Temple Grandin
Temple Grandin An Inside View of Autism........ Autism.................... ......................... ................................. ....................3 3 INTRODUCTION--------------------------------------------------------------------------3 LACKOF LACKOF SPEECH----SPEECH-----------------------------------------------------------------------------------------3 --------------------------------------------------3 RHYTHM RHYTHM AND MUSIC-------MUSIC------------------------------------------------------------------------------------------- ---------------------------------- AUDITORY AUDITORY PRO!LEMS---PRO!LEMS-------------------------------------------------------------------------- ----------------------------------------------------- TACTILE TACTILE PRO!LEMS---PRO!LEMS--------------------------------------------------------------------------------------------" ---------------------------------------" APPROACH-A#OID-----------------------------------------------------------------------" S$UEE%E MACHINE----------------------------------------------------------------------" AN&IETY AT PU!ERTY-------------------------------------------------------------------' MEDICATION-----------------------------------------------------------------------------' SLO( IMPRO#EMEN IMPRO#EMENT------T------------------------------------------------------------------------------------------) ----------------------------------) FAMILY FAMILY HISTORY----HISTORY-------------------------------------------------------------------------------------------------------) --------------------------------) SENSORY DEPRI#ATION SYMPTOMS--------------------------------------------------* DIRECT FI&ATIONS----------------------------------------------------------------------* #ISUALI%AT #ISUALI%ATION-ION------------------------------------------------------------------------------------------------+ ---------------------------------------------+ SA#ANT SA#ANT SKILLS------SKILLS---------------------------------------------------------------------------------------,, ------------------------------------------------,, DEFICITS AND A!ILITIES-------------------------------------------------------------, LEARNING TO READ--------------------------------------------------------------------, MENTOR-----MENTOR----------------------------------------------------------------------------------------------------------------------------------------------------- ,3 (HO HELPED HELPED ME RECO#ER-----RECO#ER-------------------------------------------------------------------------------------------------------------- , AUTISM PROGRAMS--------------------------------------------------------------------, REFERENCES REFERENCES -----------------------------------------------------------------------------------------------------------," ----------------------------------------,"
My Experiences with Visual Thinking Sensory ro!lems and "ommunication #ifficulties................................................$% INTRODUCT INTRODUCTION--ION---------------------------------------------------------------------------------------------------------------------------------------- ,* SOUND AND #ISUAL SENSITI#ITY---------------------------------------------------,* TACTILE E&PERIENCES----------------------------------------------------------------,+ COGNITI#E #ERSUS SENSORY--------------------------------------------------------, (HAT IS #ISUAL THINKING.--------------------------------------------------------- COMMUNICATION----------------------------------------------------------------------" AUTISM SU!TYPES---------------------------------------------------------------------" EDUCATIONAL STRATEGIES AND SU!TYPES----------------------------------------* CAUSE OF AUTISM----AUTISM-------------------------------------------------------------------------------------+ ----------------------------------------------+ CONCLUSIONS--------------------------------------------------------------------------3/
My Mind is a &e! 'rowser( )ow eople eople with Autism Autism Think 33
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M0 mind i1 a (e2 2r41er------------------------------------------------------------33 Unma15in6 Talen7----------------------------------------------------------------------3 I 1ee 78e de9i1in de9i1in pr9e11----pr9e11------------------------------------------------------------3" -------------------------------------------------------3" Animal Animal de9i1in de9i1in ma5in6-----ma5in6--------------------------------------------------------------------------------------3" -------------------------------3" T8in5in6 in a:di 7ape1----------------------------------------------------------------3" Pie9in6 78e de7ail1 76e78er-----------------------------------------------------------3" Di17:r2in6 1:nd1----------------------------------------------------------------------3' Prpr7inal 78in5in6------------------------------------------------------------------3' Re;eren9e1------------------------------------------------------------------------------3)
Thinking In ictures.................. ictures............................... ......................... ......................... ................ ...3% 3% Di;;eren7 (a01 ; T8in5in6------------------------------------------------------------, Pr9e11in6 Nn
Teaching Tips for "hildren and Adults with Autism.............*+ ,re-uently ,re-uently Asked uestions uestions a!out Autism ....................... ................. ......./3 ./3 "hoosing the 0ight 1o! for eople with Autism or Asperger2s Asperger2s Syndrome Syndrome .................. ...................................... ....................../ ../ E4aluating the Effects of Medication..................................56 Social ro!lems( 7nderstanding Emotions and #e4eloping Talents .................................... ..................................................... .................58 58 Making the Transition from the &orld of School into the &orld of &ork ......................................55 9enius May 'e an A!normality( Educating Students with Asperger2s Syndrome: Syndrome: or or )igh ,unctioning ,unctioning Autism ............5+ E4aluating the Effects of Medication..................................3
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M0 mind i1 a (e2 2r41er------------------------------------------------------------33 Unma15in6 Talen7----------------------------------------------------------------------3 I 1ee 78e de9i1in de9i1in pr9e11----pr9e11------------------------------------------------------------3" -------------------------------------------------------3" Animal Animal de9i1in de9i1in ma5in6-----ma5in6--------------------------------------------------------------------------------------3" -------------------------------3" T8in5in6 in a:di 7ape1----------------------------------------------------------------3" Pie9in6 78e de7ail1 76e78er-----------------------------------------------------------3" Di17:r2in6 1:nd1----------------------------------------------------------------------3' Prpr7inal 78in5in6------------------------------------------------------------------3' Re;eren9e1------------------------------------------------------------------------------3)
Thinking In ictures.................. ictures............................... ......................... ......................... ................ ...3% 3% Di;;eren7 (a01 ; T8in5in6------------------------------------------------------------, Pr9e11in6 Nn
Teaching Tips for "hildren and Adults with Autism.............*+ ,re-uently ,re-uently Asked uestions uestions a!out Autism ....................... ................. ......./3 ./3 "hoosing the 0ight 1o! for eople with Autism or Asperger2s Asperger2s Syndrome Syndrome .................. ...................................... ....................../ ../ E4aluating the Effects of Medication..................................56 Social ro!lems( 7nderstanding Emotions and #e4eloping Talents .................................... ..................................................... .................58 58 Making the Transition from the &orld of School into the &orld of &ork ......................................55 9enius May 'e an A!normality( Educating Students with Asperger2s Syndrome: Syndrome: or or )igh ,unctioning ,unctioning Autism ............5+ E4aluating the Effects of Medication..................................3
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An In1ide #ie4 ; A:7i1m Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e Uni
I am a 44-yea 44-yearr old autist autistic ic woman woman who has a succes successfu sfull interna internatio tional nal career career design designing ing livestock equipment. I completed my Ph.. in !nimal "cience at the #niversity of Illinois in #r$ana and I am now an !ssistant Professor of !nimal "cience at %olorado "tate #niversity. &arly intervention at age 2 1'2 helped me overcome my handicap. (wo of the su$)ects su$)ects covered in this chapter chapter are the frustration frustration of not $eing a$le to speak and sensory pro$lems. *y senses were oversensitive to loud noise and touch. +oud noise hurt my ears and I withdrew from touch to avoid over-whelming sensation. I $uilt a squee,ing machine which helped me to calm my nerves and to tolerate touching. !t pu$e pu$ert rty y horri horri$l $le e ani aniet ety y /nerv /nerve/ e/ atta attack cks s star starte ted d and and they they $eca $ecame me wors worse e with with age. age. !ntidepressant medication relieved the aniety. In the last section of the chapter directing my fiations into constructive activities and a career will $e discussed along with the importance of a mentor. *y skill and deficit areas are covered in detail. !ll my thinking is visual like videos played in my imagination. &ven a$stract concepts such as getting along with other people are visuali,ed through the use of door imagery. LACKOF SPEECH
0ot $eing a$le to speak was utter frustration. If adults spoke directly to me I could understand everything they said $ut I could not get my words out. It was like a $ig stutter. If I was placed in a slight stress situation words would sometimes overcome the $arrier and come out. *y speech therapist knew how to intrude into my world. "he would hold me $y my chin and made me look in her eyes and say /$all./ !t age /$all/ came out /$ah/ said with great stress. If the therapist pushed too hard I threw a tantrum and if she did not intrude far enough no progress was made. *y mother and teachers wondere d why I screamed. "creaming was the only way I could communicate. ften I would logically think to myself /I am going to scream now $ecause I want to tell some$ody I don3t want to do something./ It is interesting that my speech resem$led the stressed speech in young children who have had tumors removed from the cere$ellum. ekate 5ru$$ !ram 6ahn and atcheson 189:; found that cancer surgeries that lesioned the vermus deep nuclei and $oth hemispheres of the cere$ellum caused temporary speech loss in normal children.
ernigan 1899; reported that 14 out of 19 high- to moderate- functioning autistics had undersi,ed cere$ellar vermal lo$ules
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levers at once is impossi$le. (his may eplain why I do not readily learn a musical instrument even though I have innate musical talent for pitch and melody. (he only musical instrument I mastered is whistling with my mouth. RHYTHM AND MUSIC
(hroughout elementary school my speech was still not completely normal. ften it took me longer than other children to start getting my words out. "inging however was easy. I have perfect pitch and I can effortlessly hum $ack the tune of a song I have heard only once or twice. I still have many pro$lems with rhythm. I can clap out a rhythm $y myself $ut I am una$le to synchroni,e my rhythm with some$ody else3s rhythm. !t a concert I am una$le to clap in time with the music with the rest of the people. ! lack of rhythm during autistic piano playing is noted $y Park and =ouderian 1874;. hythm pro$lems may $e related to some autistic speech pro$lems. 0ormal $a$ies move in synchroni,ation with adult speech %ondon B "ander 1874;. !utistics fail to do this. %ondon 189:; also found that autistics and to a lesser etent dysleics and stutterers have a defective orienting response. ne ear hears a sound sooner that the other. (he asynchrony $etween ears is some- times over one second. (his may help eplain certain speech pro$lems. People still accuse me of interrupting. ue to a faulty rhythm sense it is difficult to determine when I should $reak into a conversation. Collowing the rhythmic e$$ and rise of a conversation is difficult. AUDITORY PRO!LEMS
*y hearing is like having a hearing aid with the volume control stuck on /super loud./ It is like an open microphone that picks up everything. I have two choicesD turn the mike on and get deluged with sound or shut it off. *other reported that sometimes I acted like I was deaf. 6earing tests indicated that my hearing was normal. I can3t modulate incoming auditory stimulation. *any autistics have pro$lems with modulating sensory input rnit, 189:;. (hey either overreact or under-react. rnit, 189:; suggests that some cognitive deficits could $e caused $y distorted sensory input. !utistics also have profound a$normalities in the neurological mechanisms that control the capacity to shift attention $etween different stimuli %ourchesne 1898;. I am una$le to talk on the phone in a noisy office or airport. &very$ody else can use the phones in a noisy environment $ut I can3t. If I try to screen out the $ackground noise I also screen out the phone. ! friend of mine a high-functioning autistic was una$le to hear a conversation in a relatively quiet hotel lo$$y. "he has the same pro$lem I have ecept worse. !utistics must $e protected from noises that $other them. "udden loud noises hurt my ears like a dentist3s drill hitting a nerve. ! gifted autistic man from Portugal wrote /I )umped out of my skin when animals made noises/ Ehite B Ehite 1897;. !n autistic child will cover his ears $ecause certain sounds hurt. It is like an ecessive startle reaction. ! sudden noise even a relatively faint one; will often make my heart race. %ere$ellar a$normalities may play a role in increased sound sensitivity. esearch on rats indicates that the vermus of the cere$ellum modulates sensory input %rispino B ?ullock 1894;. "timulation of the cere$ellum with an electrode will make a cat hypersensitive to sound and touch %ham$ers 1847;. I still dislike places with confusing noise such as shopping malls. 6igh-pitched continuous noises such as $athroom vent fans or hair dryers are annoying. I can shut down my hearing and withdraw from most noise $ut certain frequencies cannot $e shut out. It is impossi$le for an autistic child to concentrate in a classroom if he is $om$arded with noises that $last through his $rain like a )et engine. 6igh shrill noises were the worst. ! low rum$le has no effect $ut an eploding firecracker hurts my ears. !s a child my governess used to punish me $y popping a paper $ag. (he sudden loud noise was torture. &ven now I still have pro$lems with tuning out. I will $e listening to a favorite song on the radio and then reali,e I missed half of it. *y hearing )ust shuts off. In college I had to constantly keep taking notes to prevent tuning out. (he young man from Portugal also wrote
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that carrying on a conversation was very difficult. (he other person3s voice faded in and out like a distant radio station Ehite B Ehite 1897;. TACTILE PRO!LEMS
I often mis$ehaved in church $ecause the petticoats itched and scratched. "unday clothes felt different than everyday clothes. *ost people adapt to the feeling of different types of clothing in a few minutes. &ven now I avoid wearing new types of underwear. It takes me three to four days to fully adapt to new ones. !s a child in church skirts and stockings drove me cra,y. *y legs hurt during the cold winter when I wore a skirt. (he pro$lem was the change from pants all week to a skirt on "unday. If I had worn skirts all the time I would not have $een a$le to tolerate pants. (oday I $uy clothes that feel similar. *y parents had no idea why I $ehaved so $adly. ! few simple changes in clothes would have improved my $ehavior. "ome tactile sensitivities can $e desensiti,ed. &ncouraging a child to ru$ the skin with different cloth tetures often helps. (he nerve endings on my skin were supersensitive. "timuli that were insignificant to most people were like %hinese water torture. !yres 1878; lists many good suggestions on methods to desensiti,e the tactile system. APPROACH-A#OID
In my $ook Emergence: Labeled Autistic 5randin B "cariano 189A; I descri$e craving pressure stimulation. It was an approach-avoid situation. I wanted to feel the good feeling of $eing hugged $ut when people hugged me the stimuli washed over me like a tidal wave. Ehen I was : years old I used to daydream a$out a mechanical device I could get into that would apply comforting pressure. ?eing a$le to control the device was very important. I had to $e a$le to stop the stimulation when it $ecame too intense. Ehen people hugged me I stiffened and pulled away to avoid the all- engulfing tidal wave of stimulation. (he stiffening up and flinching was like a wild animal pulling away. !s a child I used to like to get under the sofa cushions and have my sister sit on them. !t various autism conferences I have had F or 4F parents tell me that their autistic child seeks deep pressure stimuli. esearch $y "chopler 18A:; indicated that autistic children prefer proimal; sensory stimulation such as touching tasting and smelling to distal sensory stimulation such as hearing or seeing. S$UEE%E MACHINE
!t age 19 I $uilt a squee,ing machine. (his device is completely lined with foam ru$$er and the user has complete control over the duration and amount of pressure applied. ! complete description of the machine is in 5randin 189 1894; and 5randin and "cariano 189A;. (he machine pro- vides comforting pressure to large areas of the $ody. It took me a long time to learn to accept the feeling of $eing held and not try to pull away from it. eports in the literature indicate that autistics lack empathy ?emporad 1878G
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"quee,e machines have $een in use in clinics working with autistic and hyperactive children Cigures A-1 and A-2;. +orna @ing an occupational therapist in Phoeni !ri,ona reports that it has a calming effect on hyperactive $ehavior. (herapists have found that deep pressure stimulation has a calming effect !yres 1878;. ?oth animal and human studies have shown that pressure stimulation reduces nervous system arousal @uma,awa 18AG *el,ack @onrad B u$ro$sky 18A8G (akagi B @o$agasi 18:A;. Pressure on the sides of the $ody will induce relaation in pigs 5randin odman B "huster 1 898;. AN&IETY AT PU!ERTY
!s a child I was hyperactive $ut I did not feel /nervous/ until I reached pu$erty. !t pu$erty my $ehavior took a $ad turn for the worse. 5ill$erg and "chaumann 1891; descri$e $ehavior deterioration at pu$erty in many autistics. "hortly after my first menstrual period the aniety attacks started. (he feeling was like a constant feeling of stage fright all the time. Ehen people ask me what it is like I say />ust imagine how you felt when you did something really aniety provoking such as your first pu$lic speaking engagement. 0ow )ust imagine if you felt that way most of the time for no reason./ I had a pounding heart sweaty palms and restless movements. (he /nerves/ were almost like hypersensitivity rather than aniety. It was like my $rain was running at 2FF miles an hour instead of AF miles an hour. +i$rium and
In the net section I am going to descri$e my eperiences with medication. (here are many autism su$types and a medication that works for me may $e useless for another case. Parents of autistic children should o$tain medical advice from professionals who are knowledgea$le of the latest medical research. I read in the medical li$rary that antidepressant drugs such as (ofranil Imipramine; were effective for treating patients with endogenous aniety and panic "heehan ?eh ?allenger B >aco$sen 189F;. (he symptoms descri$ed in this paper sounded like my symptoms so I
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decided to try (ofranil. Cifty mg of (ofranil at $edtime worked like magic. Eithin a week the feelings of nervousness started to go away. !fter $eing on (ofranil for four years I switched to :F mg 0orpramin desipramine; which has fewer side effects. (hese pills have changed my life. %olitis and other stress-related health pro$lems were cured. r. Paul 6ardy in ?oston has found that (ofranil and Pro,ac fluoetine; are $oth effective for treating certain high-functioning autistic adolescents and adults. ?oth r. 6ardy and r. >ohn atey personal communication 1898; have learned that very small doses of these drugs must $e used. (hese doses are usually much lower than the dose prescri$ed for depression. (oo high a dose can cause agitation aggression or ecitement and too low a dose will have no effect. *y /nerve/ attacks would go in cycles and I have had relapses while on the drug. It took will power to stick with the :F mg dose and let the relapse su$side on its own. (aking the medicine is like ad)usting the idle screw on a car3s car$uretor. ?efore taking the drug the engine was racing all the time. 0ow it runs at normal speed. I no longer fiate and I am no longer /driven./ Pro,ac and !nafranil clomipramine; have $een very effective in autistics who have o$sessive-compulsive symptoms or o$sessive thoughts which race through their heads. (he effective doses for Pro,ac have ranged from two 2F mg capsules per week to 4F mg per day. (oo high a dose will cause agitation and ecitement. If an autistic person $ecomes agitated the dose should $e lowered. ther promising drugs for aggressive autistic adolescents and adults are $eta $lockers. ?eta $lockers greatly reduce aggressive $ehavior atey et al. 1897;. SLO( IMPRO#EMENT
uring the eight years I have $een taking antidepressants there has $een a steady improvement in my speech socia$ility and posture. (he change was so gradual that I did not notice it. &ven though I felt relief from the /nerves/ immediately it takes time to unlearn old $ehavior patterns. Eithin the last year I had an opportunity to visit an old friend who had known me $efore I started taking antidepressants. *y friend ?illie 6art told me I was a completely different person. "he said I used to walk and sit in a hunched-over position and now my posture is straight. &ye contact had improved and I no longer shifted around in my chair. I was also surprised to learn that I no longer seemed to $e out of $reath all the time and I had stopped constantly swallowing.
(here is much that can $e learned from family history. uring my travels to autism conferences I have found many families with affective disorder in the family history. (he relationship $etween autism and affective disorder has also $een reported in the literature 5ill$erg B "chaumann 1891;. Camily histories of high-functioning autistics often contain giftedness aniety or panic disorder depression food allergies and learning disorders. In many of the families I have interviewed the disorders were never formally diagnosed $ut careful questioning revealed them. *y own family history contains nervousness and aniety on $oth sides. *y grandmother has mild depression and (ofranil has also worked wonders for her. "he is also very sensitive to loud noise. "he told me that when she was a little girl the sound of coal going down the chute was torture. *y sister is $othered $y confusing noise from several sources. n my father3s side there is eplosive temper perseveration on one topic etreme nervousness and food
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allergies. ?oth sides of my family contain artists. (here are also signs of immune system a$normalities in myself and my si$lings. I had shingles in my thirties and my $rother had them at age 4. *y sister had serious ear infections similar to the ear infections in many young autistics. *y dad $rother and myself all have ec,ema.
SENSORY DEPRI#ATION SYMPTOMS
!nimals placed in an environment that severely restricts sensory input develop many autistic symptoms such as stereotyped $ehavior hyperactivity and self-mutilation 5randin 1894;. Ehy would an autistic and a lion in a $arren concrete ,oo cage have some of the same symptomsH Crom my own eperience I would like to suggest a possi$le answer. "ince incoming auditory and tactile stimulation often overwhelmed me I may have created a selfimposed sensory restriction $y withdrawing from input that was too intense. *other told me that when I was a $a$y I stiffened and pulled away. ?y pulling away I did not receive the comforting tactile input that is required for normal development. !nimal studies show that sensory restriction in puppies and $a$y rats has a very detrimental effect on $rain development. Puppies raised in a $arren kennel $ecome hyper-ecita$le and their &&5s $rain waves; still contain signs of overarousal si months after removal from the kennel *el,ack B ?urns 18A:;. !utistic children also have a desynchroni,ed &&5 which indicates high arousal 6utt 6utt +ee B unstead 18A:;. (rimming the whiskers on $a$y rats causes the parts of the $rain that receive input from the whiskers to $ecome oversensitive "imons B +and 1897;. (he a$normality is relatively permanentG the $rain areas are still a$normal after the whiskers grow $ack. "ome autistics also have overactive $rain meta$olism umsey et al. 189:;. I often wonder if I had received more tactile stimulation as a child would I have $een less /hyper/ as an adultH 6andling $a$y rats produces less emotional adults who are more willing to eplore a ma,e enen$ert *orton @line B 5rota 18A2G &hrlich 18:8;. (actile stimulation is etremely important for $a$ies and aids their development %asler 18A:;. (herapists have found that children who withdraw from comforting tactile stimulation can learn to en)oy it if their skin is carefully desensiti,ed. u$$ing the skin with different cloth tetures often helps. eep pressure stimulation also reduces the urge to pull away. I was $orn with sensory pro$lems due to cere$ellar a$normalities; $ut perhaps secondary neurological damage is caused $y withdrawal from touching. !utopsies of five autistic $rains indicated that cere$ellar a$normalities occur during fetal development and many areas of the lim$ic systems were immature and a$normal ?auman 1898;. (he lim$ic system does not fully mature until two years after $irth. *ay$e withdrawal from touching made some $ehavior pro$lems worse. In my $ook I descri$e stupid / $athroom/ fiations that got me into a lot of trou$le. !n interesting paper $y *c%ray 1879; shows a link $etween a lack of tactual stimulation and ecessive mastur$ation. *astur$ation stopped when the children received more affection and hugging. Perhaps the /$athroom/ fiation would never have occurred if I could have en)oyed affection and hugging. +ately there has $een a lot of pu$licity a$out holding therapy where an autistic child is forci$ly held and hugged until he stops resisting. If this had $een done to me I would have found it highly aversive and stressful. "everal parents of autistic children have told me that a gentler form of holding therapy is effective and it improved eye contact language and socia$ility. Powers and (horworth 189:; report a similar result. Perhaps it would $e $eneficial if autistic $a$ies were gently stroked when they pulled away. *y reaction was like a wild animal. !t first touching was aversive and then it $ecame pleasant. In my opinion tactual defensiveness should $e $roken down slowly like taming an animal. If a $a$y could $e desensiti,ed and learn to en)oy comforting tactile input possi$le future $ehavior pro$lems could $e reduced.
DIRECT FI&ATIONS
(oday I have a successful career designing livestock equipment $ecause my high school
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science teacher *r. %arlock used my fiation on cattle chutes to motivate me to study psychology and science. 6e also taught me how to use the scientific indees. (his knowledge ena$led me to find out a$out (ofranil. Ehile the school psychologist wanted to take my squee,e machine away *r. %arlock encouraged me to read scientific )ournals so I could learn why the machine had a relaing effect. Ehen I moved out to !ri,ona to go to graduate school I went out to the feedlots to study the reactions of the cattle in squee,e chutes. (his was the $eginning of my career. (oday I travel all over the world designing stockyards and chutes for ma)or meat-packing firms. I am a recogni,ed leader in my field and have written over 1FF technical and scientific papers on livestock handling 5randin 1897;. If the psychologists had $een successful in taking away my squee,e machine may$e I would $e sitting somewhere rotting in front of a (< instead of writing this chapter. "ome of the most successful high-functioning autistics have directed childhood fiations into careers ?emporad 1878G 5randin B "cariano 18A9G @anner 1871;. Ehen @anner 1871; followed up his original 11 cases there were two ma)or successes. (he most successful person turned a childhood fiation on num$ers into a $ank teller3s )o$. (he farmer who reared him found goals for his num$er fiationG he told him he could count the corn rows if he plowed the field. *any of my fiations initially had a sensory $asis. In the fourth grade I was attracted to election posters $ecause I liked the feeling of wearing the posters like a sandwich man. ccupational therapists have found that a weighted vest will often reduce hyperactivity. &ven though the poster fiation started out with a sensory $asis I $ecame interested in the election. *y teachers should have taken advantage of my poster fiation to stimulate and interest in social studies. %alculating electoral college points would have motivated me to study math. eading could have $een motivated $y having me read newspaper articles a$out the people on the posters. If a child is interested in vacuum cleaners then use a vacuum-cleaner instruction $ook as a tet. !nother one of my fiations was automatic glass sliding doors. Initially I was attracted to the doors $ecause I liked the sensation of watching them move $ack and forth. (hen gradually the doors took on other meanings which I will talk a$out in the net section. In a high-functioning adolescent and interest in sliding doors could $e used to stimulate science interests. if my teacher had challenged me to learn how the electronic $o that opened the door worked I would have dived head first into electronics. Ciations can $e tremendous motivators. (eachers need to use fiations to motivate instead of trying to stamp them out. ! narrow fiated interest needs to $e $roadened into constructive activities. (he principle can also $e used with lower- functioning childrenG "imons and "a$ine 1897; list many good eamples. Ciations need to $e differentiated from stereotypies such as hand flapping or rocking. ! fiation is an interest in something eternal such as airplanes radio or sliding doors. &ngaging in stereotypic $ehavior for long periods of time may $e damaging to the nervous system. In one eperiment pigs in a $arren pen that engaged in large amounts of stereotyped rooting on each other had a$normal dendritic growth in the somatosensory corte 5randin 1898;.
#ISUALI%ATION
!ll my thinking is visual. Ehen I think a$out a$stract concepts such as getting along with people I use visual images such as the sliding glass door. elationships must $e approached carefully otherwise the sliding door could $e shattered. ane and >oe was like the #.". and %anada squa$$ling
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over the trade agreement. !lmost all my memories relate to visual images of specific events. If some$ody says the word /cat/ my images are of individual cats I have known or read a$out. I do not think a$out a generali,ed cat. *y career as a designer of livestock facilities maimi,es my talent areas and minimi,es my deficits. I still have pro$lems handling long strings of ver$al information. If directions from a gas station contain more than three steps I have to write them down. "tatistics are etremely difficult $ecause I am una$le to hold one piece of information in my mind while I do the net step. !lge$ra is almost impossi$le $ecause I can3t make a visual image and I mi up steps in the sequence. (o learn statistics I had to sit down with a tutor and write down the directions for doing each test. &very time I do a t-test or a chi-square I have to use the notes. I have no pro$lem understanding the principles of statistics $ecause I can see the normal or skewed distri$utions in my head. (he pro$lem is I cannot remem$er the sequence for doing the calculations. I can put a regression line on a graph full of dots visually. (he first time I tried it I was off only a few degrees. I also have many dysleic traits such as reversing num$ers and miing up similar-sounding words such as /over/ and /other./ ight and left are also mied up.
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a child my parents and teachers encouraged my artistic talent. It is important to nurture talents. iscussions with other high-functioning autistics have revealed visual methods of thinking on tasks that are often considered non-visual. ! $rilliant autistic computer programmer told me that he visuali,ed the program tree in his mind and then )ust filled in the code on each $ranch. ! gifted autistic composer told me that he made /sound pictures./ I was good at $uilding things $ut when I first started working with drawings it took time to learn how the lines on a drawing related to the picture in my imagination. Ehen I $uilt a house for my aunt and uncle I had difficulty learning the relationship $etween sym$olic markings on the drawings and the actual construction. (he house was $uilt $efore I learned drafting. 0ow I can instantly translate a drawing into a mental image of a finished structure. Ehile agoni,ing over the house plans I was a$le to pull up pictures out of my memory of a house addition that was $uilt when I was eight. *ental images from my childhood memory helped me install windows light switches and plum$ing. I replayed the /videos/ in my imagination.
SA#ANT SKILLS
"tudies have shown that when autistic savants $ecome less fiated and more social they lose their savant skills such as card counting calendar calculation or art skills imland B Cein 1899;. "ince I started taking the medication I have lost my fiation $ut I have not lost my visuali,ation skill. "ome of my $est work has $een done while on the medication. *y opinion is that savants lose their skill $ecause they lose the fiated attention. %ard counting shown in the Rain Man movie; is no mystery to me. I think savants visuali,e the cards $eing dealt onto a ta$le in a pattern like a series of clocks or a Persian rug pattern. (o tell which cards are still in the deck they simply look at their patterns. (he only thing that prevents me from card counting or calendar calculation is that I no longer have the concentration to hold a visual image completely steady for a long period of time. I speculate that sociali,ed savants still retain their visuali,ation skills. I still have the perfect pitch skill even though I don3t use it. If I had greater concentration I could sing $ack much longer songs after hearing them once. In my own case the strongest visual images are of things that evoked strong emotions such as important $ig )o$s. (hese memories never fade and they remain accurate. 6owever I was una$le to recall visual images of the houses on a frequently traveled road until I made an effort to attend to them. ! strong visual image contains all details and it can $e rotated and made to move like a movie. Eeaker images are like slightly out-of-focus pictures or may have details missing. Cor eample in a meat-packing plant I can accurately visuali,e the piece of equipment I designed $ut I am una$le to remem$er things I do not attend to such as the ceiling over the equipment $athrooms stairways offices and other areas of little or not interest. *emories of items of moderate interest grow ha,y with time. I tried a little memory eperiment at one of my )o$s. !fter $eing away from the plant for F days I tried recalling a part of the plant that I had attended to poorly and another part I had attended to intently. I had not designed either of these places. (he first place was the plant conference room and the other was the entrance to the room that housed my equipment. I was a$le to draw a fairly accurate map of the office $ut I made ma)or mistakes on conference-room furniture and ceiling covering. (he room I visuali,ed was plain and lacked detail. n the other hand I visuali,ed the entrance door to the equipment room very accurately $ut made a slight mistake on the door-handle style. (he visuali,ed door had much greater detail than the visuali,ed conference room. (he conference room was not attended to even though I negotiated with the plant managers in that room. (alents need to $e nurtured and $roadened out into something useful. 0adia a well-known autistic case drew wonderful perspective pictures as a child "eifel 1877;. Ehen she gained rudimentary social skills she stopped drawing. Possi$ly the talent could have $een revived with encouragement from teachers. "eifel 1877; descri$es how 0adia drew pictures on napkins and waste papers. "he needed proper drawing equipment. (reffert 1898; reported on
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several savants who did not lose their savant skills when they $ecame more social. #se of savant skills was encouraged. !t the age of 29 my drafting drastically improved after I o$served a talented draftsman named avid. ?uilding the house taught me how to understand $lueprints $ut now I had to learn to draw them. Ehen I started drawing livestock facilities I used avid3s drawings as models. I had to /pretend/ I was avid. !fter $uying a drafting pencil )ust like avid3s I laid some of his drawings out and then proceeded to draw a loading ramp for cattle. I )ust copied his style like a savant playing music ecept my ramp was a different design. Ehen it was finished I couldn3t $elieve I had done it.
DEFICITS AND A!ILITIES
Cive years ago I took a series of tests to determine my a$ilities and handicaps. n the 6iskey 0e$raska "patial easoning test my performance was at the top of the norms. n the Eoodcock->ohnson "patial elations test I only got an average score $ecause it was a timed speed test. I am not a fast thinkerG it takes time for the visual image to form. Ehen I survey a site for equipment at a meat-packing plant it takes 2F to F minutes of staring at the $uilding to fully imprint the site in my memory. nce this is done I have a /video/ I can play $ack when I am working on the drawing. Ehen I draw the image of the new piece of equipment gradually emerges. !s my eperience increased I needed fewer measurements to properly survey a )o$. n many remodeling )o$s the plant engineer often measures a whole $unch of stuff that is going to $e torn out. 6e can3t visuali,e what the $uilding will look like when parts of it are torn out and a new part is added. !s a child I got scores of 12F and 17 on the Eechsler. I had superior scores in *emory for "entences Picture ohnson. n *emory for 0um$ers I $eat the test $y repeating the num$ers out loud. I have an etremely poor long-term memory for things such as phone num$ers unless I can convert them to visual images. Cor eample the num$er A: is retirement age and I imagine some$ody in "un %ity !ri,ona. If I am una$le to take notes I cannot remem$er what people tell me unless I translate the ver$al information to visual pictures. ecently I was listening to a taped medical lecture while driving. (o remem$er information such as the drug doses discussed on the tape I had to create a picture to stand for the dose. Cor eample FFmg is a foot$all field with shoes on it. (he shoes remind me that the num$er is FF feet not yards. I got a second-grade score on the Eoodcock->ohnson ?lending su$test where I had to identify slowly sounded-out words. (he
LEARNING TO READ
*other was my salvation for reading. I would have never learned to read $y the method that requires memori,ation of hundreds of words. Eords are too a$stract to $e remem$ered. "he taught me with old-fashioned phonics. !fter I la$oriously learned all the sounds I was a$le to sound out words. (o motivate me she read a page and then stopped in an eciting part. I had to read the net sentence. 5radually she read less and less. *rs. avid E. &astham in %anada taught her autistic son to read in a similar manner using some *ontessori methods. *any
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teachers thought the $oy was retarded. 6e learned to communicate $y typing and he wrote $eautiful poetry. ouglas ?iklen at "yracuse #niversity has taught some nonver$al autistic people to write fluently on the typewriter. (o prevent perseveration on a single key and key targeting mistakes the person3s wrist is supported $y another person. ! visuali,ed-reading method developed $y *iller and *iller 1871; would also have $een helpful. (o learn ver$s each word has letters drawn to look like the action. Cor eample /fall/ would have letters falling over and /run/ would have letters that looked like runners. (his method needs to $e further developed for learning speech sounds. +earning the sounds would have $een much easier if I had a picture of a choo-choo train for /ch/ and a cat for hard /c/ sound. Cor long and short vowels long /a/ could $e represented $y a picture of some$ody praying. (his card could $e used for $oth /pr/ and long /a/ $y having a circle around /pr/ on one card and the /a/ on another. !t first reading out loud was the only way I could read. (oday when I read silently I use a com$ination of instant visuali,ation and sounding words. Cor eample this phrase from a maga,ine - /stop several pedestrians on a city street/ - was instantly seen as moving pictures. "entences that contain more a$stract words like /apparent/ or /incum$ent/ are sounded out phonetically. !s a child I often talked out loud $ecause it made my thoughts more /concrete/ and /real./ (oday when I am alone designing I will talk out loud a$out the design. (alking activates more $rain regions than )ust thinking. MENTOR
/! skilled and imaginative teacher prepared to en)oy and $e challenged $y the child seems repeatedly to have $een a deciding factor in the success and educational placement of highfunctioning autistic children/ 0ewson awson B &verard 1892;. ?emporod 1878; also $rings forth the mentor concept. *y mentor in high school was *r. %arlock my high school science teacher. "tructured $ehavior modification methods that work with small children are often useless with a high-functioning older child with normal intelligence. I was lucky to get headed on the right path after college. (hree other high-functioning autistics were not so fortunate. ne man has a Ph.. in math and he sits at home. 6e needed some$ody to steer him into an appropriate )o$. (eaching math did not work outG he should have o$tained a research position that required less interaction with people. (he other lady has a degree in history and now works doing a $oring telephone-sales )o$. "he needs a )o$ where she can fully utili,e her talents. she al so needs a mentor to help her find an appropriate )o$ and help open doors for her. ?oth these people needed support after college and they did not receive it. (he third man did well in high school and he also sits at home. 6e has a real knack for li$rary research. If some interested person worked with him he could work for a newspaper researching $ackground information for stories. !ll three of these people need )o$s where they can make maimum use of their talents and minimi,e their deficits. !nother autistic lady I know was lucky. "he landed a graphic-arts )o$ where she was a$le to put her visuali,ation talents to good use. 6er morale was also $oosted when her paintings received recognition and were purchased $y a local $ank. 6er success with the paintings also opened up many social doors. In my own case many social doors opened after I made scenery for the college talent show. I was still considered a nerd $ut now I was a /neat/ nerd. People respect talent even if they think you are /weird./ People $ecame interested in me after they saw my drawings and pictures of my )o$s. I made myself an epert in a speciali,ed area. 6igh-functioning autistics will pro$a$ly never really fit in with the social whirl. *y life is my work. If a high- functioning autistic gets an interesting )o$ he or she will have a fulfilling life. I spend most Criday and "aturday nights writing papers and drawing. !lmost all my social contacts are with livestock people or people interested in autism. +ike the 0ewson et al. 1892; su$)ects I prefer factual non-fictional reading materials. I have little interest in novels with complicated interpersonal relationships. Ehen I do read novels I prefer straightforward stories that occur in interesting places with lots of description. (he mentor needs to $e some$ody who can provide support on several different fronts. &mployment is only one area. *any high-functioning autistics need to learn a$out $udgeting
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money how to make claims on health insurance and nutritional counseling. !s the person $ecomes more and more independent the mentor can $e phased out $ut the mentor may still $e needed if the autistic loses his )o$ or has some other crisis.
(HO HELPED ME RECO#ER
*any people ask me /6ow did you manage to recoverH/ I was etremely lucky to have the right people working with me at the right time. !t age 2 I had all the typical autistic symptoms. In 1848 most doctors did not know what autism was $ut fortunately a wise neurologist recommended /normal therapy/ instead of an institution. I was referred to a speech therapist who ran a special nursery school in her home. (he speech therapist was the most important professional in my life. !t age my mother hired a governess who kept me and my sister constantly occupied. *y day consisted of structured activities such as skating swinging and painting. (he activities were structured $ut I was given limited opportunities for choice. Cor eample on one day I could choose $etween $uilding a snowman or sledding. "he actually participated in all the activities. "he also conducted musical activities and we marched around the piano with toy drums. *y sensory pro$lems were not handled well. I would have really $enefited if I had had an occupational therapist trained in sensory integration. I went to a normal elementary school with older eperienced teachers and small classes. *other was another important person who helped my recovery. "he worked very closely with the school. "he used techniques that are used today in the most successful mainstreaming programs to integrate me into the classroom. (he day $efore I went to school she and the teacher eplained to the other children that they needed to help me. !s discussed earlier pu$erty was a real pro$lem time. I got kicked out of high school for fighting. I then moved on to a small country $oarding school for gifted children with emotional pro$lems. (he director was an innovative man and considered a /lone wolf/ $y his psychologist colleagues. (his is where I met *r. %arlock. !nother etremely helpful person was !nn my aunt. I visited her ranch during the summer. In high school and college the people that helped me the most were the creative unconventional thinkers. (he more traditional professionals such as the school psychologist were actually harmful. (hey were too $usy trying to psychoanaly,e me and take away my squee,e machine. +ater when I $ecame interested in meat-packing plants (om ohrer the manager of the local meat-packing plant took an interest in me. Cor three years I visited his plant once a week and learned the industry. *y very first design )o$ was in his plant. I want to emphasi,e the importance of a gradual transition from the world of school to the world of work. (he packing plant visits were made while I was still in college. People with autism need to $e gradually introduced to a )o$ $efore they graduate. (he autistics I discussed earlier could have ecellent careers if they had a local $usinessperson take an interest in them. AUTISM PROGRAMS
uring my travels I have o$served many different programs. It is my opinion that effective programs for young children have certain common denominators that are similar regardless of theoretical $asis. &arly intense intervention improves the prognosis. Passive approaches don3t work. *y governess was sometimes mean $ut her intense structured intervention prevented me from withdrawing. "he and my mother )ust used their good instincts. 5ood programs do a variety of activities and use more than one approach. ! good little children3s program should include flei$le $ehavior modification speech therapy eercise sensory treatment activities that stimulate the vesti$ular system and tactile desensiti,ation; musical activities contact with nor mal children and lots of love. (he effectiveness of different types of programs is going to vary from case to case. ! program that is effective for one case may $e less effective for another.
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REFERENCES
!yres >. !. 1878;. Sensory integration and the child +os !ngelesD Eestern Psychological "ervices. ?auman *. 1898;. (he anatomy of autism. In !on"erence #roceedings: Autism Society o" America pp. 1F-12;. Eashington %D !utism "ociety of !merica. ?auman *. B @emper (.+. 189:;. 6istoanatomic o$servations of the $rain in early infantile autism. $eurology, %&, 9AA-974. ?emporad >.. 1878;. !dult recollections of a formerly autistic child. 'ournal o" Autism and (e)elopmental (isorders,*,178-187. ?hatara <. %lark .+. !rnold +.&. 5unsett . B "melt,er .>. 1891;. 6yperkinesis treated with vesti$ular stimulationD !n eploratory study. +iological #sychiatry, -, 2A8-278. ?iklen . %ommunication un$oundD !utism and prais. .ar)ard Educational Re)ie/, 0, 28114. %asler +. 18A:;. &ffects of etra tactile stimulation on a group of institutionali,ed infants. Genetic #sychology Monographs, 1-, 17-17:. %ham$ers E.E. 1847;. &lectrical stimulation of the interior cere$ellum of the cat. American 'ournal o" Anatomy, 20, ::-8. %ondon E.". 189:;. "ound-film microanalysisD ! means of correlating $rain and $ehavior. In C.uffy B 0.5eschwind &ds.; (ysle3ia: A neuro4scienti"ic approach to clinical e)aluation ?ostonD +ittle ?rown. %ondon E. B "ander +. 1874;. 0eonate movement is synchroni,ed with adult speech. Science, -2%, 88-1F1. %ourchesne &. 1898;. Implications of recent neuro$iologic findings in autism In !on"erence #roceedings5 Autism Society o" America, pp. 9-8;. Eashington %D !utism "ociety of !merica. %ourchesne &. %ourchesnes-=eung . Press 5.!. 6esselink >.. B >ernigan (.+. 1899;. 6ypoplasia of cere$ellar vermal lo$ules .. @line 0.>. B 5rota +.>. 18A2;. &ffects of duration of infantile stimulation upon emotionality. !anadian 'ournal o" #sychology, -6-7, 72-7A. &hrlich !. 18:8;. &ffects of past eperience on eploratory $e havior in rats. !anadian 'ournal o" #sychology, -%687, 249-2:4. &instein !. B &instein *.E. 1897;. The collected papers o" Albert Einstein !. ?eck B P. 6avens (rans.; Princeton 0>D Princeton #niversity Press. Carah *.>. 1898;. (he neural $asis of mental imagery. Trends in $euroscience, -9, 8:-88. 5ill$erg ?. B "chaumann 6. 1891;. Infantile autism and pu$erty. 'ournal o" Autism and (e)elopmental (isorders, --, A:-71. 5randin (. 189F;. $servations of cattle $ehavior applied to the design of cattle handling facilities. Applied Animal Ethnology, , 18-1. 5randin (. 189;. +etters to the editorD /%oping strategies./ 'ournal o" Autism and (e)elopmental (isorders, -%, 217-221. 5randin (. 1894;. *y eperiences as an autistic child. 'ournal o" rthomolecular #sychiatry, -%, 144-174. 5randin (. 1897;. !nimal handling. In &. . Price &.; Farm animal beha)ior, )eterinary clinics o" $orth America . 6utt %. +ee . B unsted %. 18A:;. ! $ehavioral and electroencephalographic study of autistic children. 'ournal o" #sychiatric Research, %, 191-187.
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@anner +. 1871;. Collow-up study of eleven autistic children originally reported in 184. 'ournal o" Autism and !hildhood Schizophrenia, -, 112-14:. @uma,awa (. 18A;. eactivation of the ra$$it3s $rain $y pressure application to the skin. Electroencephalography and !linical $eurology, -&, AAF-A71. +epscky I. 1892;. Albert Einstein 0ew =orkD ?arrons. *c%ray 5.*. 1879;. &cessive mastur$ation in childhoodD ! symptom of tactile deprivation. #ediatrics, 9, 277-278. *c5imsey >.C. B Cavell >.&. 1899;. (he effects of increased physical eercise on disruptive $ehavior in retarded persons. 'ournal o" Autism and (e)elopmental (isorders, -2, 1A7-178. *el,ack . B ?urns ". @. 18A:;. 0europhysiological effects of early sensory restriction. E3perimental $eurology, -%, 1A-17:. *el,ack . @onrad @.E. B u$ro$sky ?. 18A8;. Prolonged changes in the central nervous system produced $y somatic and reticular stimulation. E3perimental $eurology, 9&, 41A-429. *iller !. B *iller &.&. 1871;. "ym$ol accentuation single-track functioning and early reading. American 'ournal o" Mental (e"iciency, 1, 11F-117. 0ewson &. awson *. B &verard P. 1892;. The natural history o" able autistic people: Their management and "unctioning in a social conte3t 0ottingham &nglandD #niversity of 0ottingham %hild evelopment #nit. rnit, &. 189:;. 0europhysiology of infantile autism. 'ournal o" the American Academy o" !hild #sychiatry, 98, 2:1-1A2. Park . B =ouderian P. 1874;. +ight and num$erD rdering principles in the world of an autistic child. 'ournal o" Autism and !hildhood Schizophrenia, 8, 1-2. Powers *.. B (horworth %.!. 189:;. (he effect of negative reinforcement on tolerances of physical contact in a preschool autistic child. 'ournal o" !linical #sychology, -8, 288-F. atey >.>. *ikkelsen &. "orgi P. uckerman ". Polakoff ". ?emporad >. ?ick P. B @adish E. 1897;. !utismD (he treatment of aggressive $ehaviors. 'ournal o" !linical #harmacology, 1, :-41. ay (.%. @ing +.>. B 5randin (. 1899;.(he effectiveness of self-initiated vesti$ular stimulation in producing speech sounds in an autistic child. 'ournal o" ccupational Therapy Research, 2, 19A-18F. ekate 6.+. 5ru$$ .+. !ram .*. 6ahn >.C. B atcheson . !. 189:;. *uteness of cere$ellar origin. Archi)es o" $eurology, 89, A87-A89. imland 5. B Cein . 1899; "pecial talents of autistic savants. In +.@. $ler B . Cein &ds.; The e3ceptional brain 0ew =orkD 5uilford. itvo &. Creeman ?.>. "chei$el !.?. uong (. o$inson 6. 5uthrie . B itvo !. 189A;. +ower Purkin)e cell counts in the cere$ella of four autistic su$)ects. American 'ournal o" #sychiatry, -8%, 9A2-9AA. umsey >.*. uara . 5rady %. apoport >.+. *argolin .!. apoport ".I. B %utler 0.. 189:;. ?rain meta$olism in autism. Archi)es o" General #sychiatry, 89, 449-4::. "chopler 6.. 18A:;. &arly infantile autism and the receptor process. Archi)es o" General #sychiatry, -%, 27-7. "eifel +. 1877;. $adia: A case o" e3traordinary dra/ing ability in an autistic child 0ew =orkD !cademic Press. "heehan .<. ?eh *.?. ?allenger >. B >aco$sen 5. 189F;. (reatment of endogenous aniety with pho$ic hysterical and hyperchondriacal symptoms. Archi)es o" General #sychiatry, %1, :1-:8. "imons . B "and P. 1897;. &arly tactile stimulation influences organi,ation of somatic sensory corte. $ature, %9, A84-A87. "imons >. B "a$ine . 1897;. The hidden child @ensington *D Eood$ine 6ouse. (akagi @. B @o$agasi ". 18:A;. "kin Pressure refle. Acta Medica et +iologica, 8, 1-7. (reffert .!. 1898;. E3traordinary people: ;nderstanding the sa)ant syndrome ?allantine ?ooks 0ew =ork. . 189:;. (he eperience of infantile autismD ! first person account $y (ony E. 'ournal o" Autism and (e)elopmental (isorders, -&, 47-:4. Ealters .5. B Ealters E.&. 189F;. ecreasing self-stimulatory $ehavior with physical eercise in a group of autistic $oys. 'ournal o" Autism and (e)elopmental (isorders, -0, 7897.
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Ehite 5.?. B Ehite *.". 1897;. !utism from the inside. Medical .ypothesis, 98, 22-228.
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M0 E?perien9e1 4i78 #i1:al T8in5in6 Sen1r0 Pr2lem1 and Cmm:ni9a7in Di;;i9:l7ie1 20 Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e Uni
In this paper I will descri$e my eperiences with autism. (he main areas I will cover are visual thinking sensory pro$lems and difficulties with communication. !fter I descri$e my eperiences I will discuss the similarities and differences $etween myself and other people with an autism diagnosis. (here is pro$a$ly a continuum of autism su$types that vary in the pattern of neurological a$normality and the severity of neurological pro$lems.
SOUND AND #ISUAL SENSITI#ITY
*y hearing is like having a sound amplifier set on maimum loudness. *y ears are like a microphone that picks up and amplifies sound. I have two choicesD 1; turn my ears on and get deluged with sound or 2; shut my ears off. *other told me that sometimes I acted like I was deaf. 6earing tests indicated that my hearing was normal. I can3t modulate incoming auditory stimulation. I discovered that I could shut out painful sounds $y engaging in rhythmic stereotypical autistic $ehavior. "ometimes I /tune out/. Cor eample I will $e listening to a favorite song on the car radio and then later reali,e that I tuned out and missed half of the song. In college I had to constantly take notes to prevent tuning out. I am una$le to talk on the telephone in a noisy office or airport. ther people can use the telephones in a noisy airport $ut I cannot. If I try to screen out the $ackground noise I also screen out the voice on the telephone. !utistic people with more severe auditory processing pro$lems are una$le to hear a conversation in a relatively quiet hotel lo$$y. !utistic people must $e protected from noises that hurt their ears. "udden loud noises hurt my ears--like a dentist3s drill hitting a nerve 5randin 1882a;. ! gifted autistic man from Portugal wroteD /I )umped out of my skin when animals made noises/ Ehite and Ehite 1897;. !n autistic child will cover his or her ears $ecause certain sounds hurt. It is like an ecessive startle reaction. ! sudden noise even a relatively faint one; will often make my heart race. I still dislike places with many different noises such as shopping centers and sports arenas. 6igh-pitched continuous noise such as $athroom vent fans or hair dryers are annoying. I can shut down my hearing and withdraw from most noise $ut certain frequencies cannot $e shut out. It is impossi$le for an autistic child to concentrate in a classroom if he or she is $om$arded with noises that $last through his or her $rain like a )et engine. 6igh-pitched shrill noises are the worst. ! low rum$le has no affect $ut an eploding firecracker hurts my ears. !s a child my governess used to pop a paper $ag to punish me. (he sudden loud noise was torture. (he fear of a noise that hurts the ears is often the cause of many $ad $ehaviors and tantrums. "ome autistic children will attempt to $reak the telephone $ecause they are afraid it will ring. *any $ad $ehaviors are triggered due to anticipation of $eing su$)ected to a painful noise. (he $ad $ehaviors can occur hours $efore the noise. %ommon noises that cause discomfort in many autistic individuals are school $ells fire alarms score $oard $u,,ers in the gym
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squealing microphone feed$ack and chairs scraping on the floor. Ehen I was a child I feared the ferry $oat that took us to our summer vacation home. Ehen the $oat3s horn $lew I threw myself on the floor and screamed. !utistic children and adults may fear dogs or $a$ies $ecause $arking dogs or crying $a$ies may hurt their ears. ogs and $a$ies are unpredicta$le and they can make a hurtful noise without warning. %hildren and adults with etreme sound sensitivity may also fear the sound of water flowing or waves "tehli 1881;. %hildren with less severe auditory sensitivity pro$lems may $e attracted to sound and visual stimuli that more severely impaired children tend to avoid. I liked the sound of flowing water and en)oyed pouring water $ack and forth $etween orange )uice cansG whereas another child may avoid the sound of flowing water. I liked the visual stimulation of watching automatic sliding doorsG whereas another child might run and scream when he or she sees an automatic sliding door. ! loud vacuum cleaner may cause fear in one autistic child and may $e a pleasura$le fiation to another child. Ehen I look at moving sliding doors I get the same pleasura$le feeling that used to occur when I engaged in rocking or other stereotypical autistic $ehaviors. "ome autistic individuals can see the flicker of florescent lights. %oleman et al. 187A; found that florescent lights increased r epetitive $ehavior in some autistic children. TACTILE E&PERIENCES
uring my travels to many autism conferences several parents have reported to me that holding therapy was $eneficial. It is not the /cure/ that some of its proponents tout $ut it has a $eneficial affect on some children. In my opinion the $enefits of holding therapy could $e o$tained through less stressful methods. I cringed when I watched the ??% show /(he
I pulled away when people tried to hug me $ecause $eing touched sent an overwhelming tidal wave of stimulation through my $ody. I wanted to feel the comforting feeling of $eing held $ut then when some$ody held me the effect on my nervous system was overwhelming. It was an approach-avoid situation $ut sensory over stimulation caused the avoidance not anger or fear as icher and appella 1898; suggest. !n autistic man interviewed $y %esaroni and 5ar$er stated that touching was not painful $ut it was overwhelming and confusing. "mall itches and scratches that most people ignored were torture. ! scratchy petticoat was like sand paper ru$$ing my skin raw. 6air washing was also awful. Ehen mother scru$$ed my hair my scalp hurt. I also had pro$lems with adapting to new types of clothes. It took several days for me to stop feeling a new type of clothing on my $odyG whereas a normal person adapts to the change from pants to a dress in five minutes. 0ew underwear causes great discomfort and I have to wash it $efore I can wear it. *any people with autism prefer soft cotton against the skin. I also liked long pants $ecause I disliked the feeling of my legs touching each other.
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Sen1r0 T8erap0
(herapists have helped many autistic children through gently applying tactile and vesti$ular stimulation !yres 1878G @ing 1898;. ne effect of this stimulation is to desensiti,e the tactile system. (his is not a cure $ut it has increased speech affection and eye contact in some children. It also helps to decrease stereotypical and self-in)urious $ehaviors. (he sensory activities are done gently as fun games and are never forced. "trong encouragement and some intrusiveness may $e used $ut a good therapist knows how far he or she can intrude $efore the stimulation $ecomes so overwhelming that the child starts crying. &ven intrusive activities are kept fun. uring the activities the therapist will also work on improving speech and esta$lishing eye contact. ay et al. 1899; found that a mute child will often start making speech sounds while he or she is swinging in a swing. "winging stimulates the vesti$ular system and the defective cere$ellum. "pinning in a chair twice a week helps to reduce hyperactivity ?hatara et al. 1891;G and non-contingent vi$ration will reduce stereotypical $ehavior *urphy 1892;. esearch has also shown that vigorous aero$ic eercise reduced maladaptive and stereotypic $ehavior &lliot et al. 1884;. 6ypersensitivity to touch can $e desensiti,ed through firmly $ut gently stroking a child with different cloth tetures !yres 1878;. (he pressure must $e firm enough to stimulate deep pressure receptors.
?oth human and animal studies indicate that deep pressure is calming and reduces arousal in the nervous system. (akagi and @o$agas 18:A; found that pressure applied to $oth sides of a person3s $ody decreased meta$olic rate pulse rate and muscle tone. 5ently pinching a ra$$it3s skin with padded clips creates a deactivated &&5 reading relaed muscle tone and drowsiness @uma,awa 18A;. Pressure gently applied to $oth sides of a pig in a padded < trough will induce sleep and relaation 5randin et al. 1898;. u$$ing and gently pinching a cat3s paw will decrease tonic activity in the dorsal column nuclei and the somatosensory corte part of the $rain that receives touch sensation; *el,ack et al. 18A8;. S:eee Ma98ine
I craved deep pressure stimulation $ut I pulled away and stiffened when my overweight aunt hugged me. In my two $ooks 5randin and "cariano 189A and 5randin 188:; I descri$e a squee,e machine I constructed to satisfy my craving for the feeling of $eing held. (he machine was designed so that I could control the amount and duration of the pressure. It was lined with foam ru$$er and applied pressure over a large area of my $ody. 5radually I was a$le to tolerate the machine holding me. (he over sensitivity of my nervous system was slowly reduced. ! stimulus that was once overwhelming and aversive had now $ecome pleasura$le. #sing the machine ena$led me to tolerate another person touching me. ! partial eplanation for the lack of empathy in autism may $e due to an oversensitive nervous system that prevents an autistic child from receiving the comforting tactile stimulation that comes from $eing hugged. I learned how to pet our cat more gently after I had used the squee,e machine. I had to comfort myself $efore I could give comfort to the cat. Ehen I handle cattle I often touch the animals $ecause it helps me to feel gentle towards them. It is important to desensiti,e an autistic child so that he'she can tolerate comforting touch. I have
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found that if I use my squee,e machine on a regular $asis that I have nicer images in my dreams. &periencing the comforting feeling of $eing held makes nasty or mean thoughts go away. "everal squee,e machines are now in use at sensory integration clinics in the #nited "tates. (herapists have found that some hyperactive and autistic children will immediately use the machine and others are so oversensitive to touch that they initially avoid the machine and other activities involving touch such as finger painting or $eing ru$$ed with different cloth tetures. ver sensitive children are gently encouraged to engage in tactile activities that they initially avoided. !n activity that was initially aversive and overwhelming gradually $ecomes pleasura$le. !ctivities involving touch $ecome pleasura$le when the nervous system $ecomes desensiti,ed. Cor eample children who cannot tolerate tooth $rushing can $e desensiti,ed through gently ru$$ing them around the mouth. Animal Rea97in1
*y reaction to $eing touched was like a wild horse flinching and pulling away. (he reactions of an autistic child to touch and a wild horse may $e similar. (he process of taming a wild animal has many similarities to an autistic child3s reaction to touch. (here are two methods that can $e used tame a wild horseD 1; forced holding and 2; gradual taming. ?oth methods work. Corced holding is quicker and more stressful than the somewhat slower gradual taming process. 5ood horse trainers only use forced holding on etremely young horses. Ehen forced holding is used on animals care is taken to avoid ecitement. (he procedure is done as quietly and gently as possi$le. (he animal is securely tied or held in a livestock restraint device. It is held tightly and is una$le to kick or thrash. uring the restraint period the trainer pets and strokes all parts of the animal3s $ody and talks gently to it. (ouching every part of the animal3s $ody is an important component of the taming procedure. (he animal is released when it is not resisting. "essions seldom last more than one hour. ! disadvantage of this procedure is that forced restraint is stressful. (he taming approach is done more gradually. I have trained sheep to enter a device similar to my squee,e machine repeatedly 5randin 1898;. (he sheep were gradually introduced to the device. !t first they )ust stood in it and then pressure was applied for increasing amounts of time. 6orse trainers have found that nervous horses $ecome easier to handle if they are ru$$ed and $rushed frequently. !t first the horse may flinch $ut gradually it will start relaing when stroked. +ike the autistic child touching that was initially aversive $ecomes pleasura$le. ! stimulus that was once actively avoided is now actively sought out. COGNITI#E #ERSUS SENSORY
In this paper I have concentrated on the sensory aspects of autism and have not discussed $ehavioral and cognitive thinking; factors. %ognitive and $ehavioral aspects are important $ut I concentrated on the sensory aspects $ecause these are often neglected. "ensory processing pro$lems may eplain some autistic $ehaviors and differences in cognitive processes may eplain others. %ere$ellar and $rain stem a$normalities are a pro$a$le eplanation of many sensory pro$lems $ut they would not eplain cognitive differences such as concrete thinking and unusual visual spatial skills. (he cognitive differences $etwe en autistic and normal children are pro$a$ly due to other $rain a$normalities. !utopsies of nine autistic $rains revealed a$normalities in the cere$ellum hippocampus amygdala and other parts of the lim$ic system ?auman 1881 and ?auman and @emper 1884;. (hese areas are involved with learning and memory. ?rain wave &&5; studies indicated that autistic children have severe a$normalities in their capacity to shift attention $etween visual and auditory stimuli %ourchesne et al. 1898;. ?rain structures that control attention shift are connected to the cere$ellar vermis. !$normalities in attention shifting may $e the $asis of perseverate repetitive; $ehavior and some social deficits. (his may possi$ly eplain why treatments that stimulate the cere$ellum and certain sensory treatments often improve overall $ehavior. Curther research has shown that the amygdala emotion center; in the $rain is underdeveloped. (his may eplain some of the social deficits of autism. ?rain scans have
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revealed that some of the circuits $etween the frontal corte and amygdala are not functioning normally 6a,nader et al. 1887;. (his may force a person with autism to use intellect and logic to make social decisions instead of emotion cues. Sen1r0 Depri
(he symptoms of sensory deprivation in animals and many autistic symptoms are similar. !nimals confined to a $arren environment are ecita$le and engage in stereotypies self-in)ury hyperactivity and distur$ed social relations 5randin 1898$G *ason 18AFG 6arlow and immerman 18:8;. !n animal in a $arren environment engages in stereotypies in an attempt to stimulate itself. Ehy would a leopard in a concrete cell at the ,oo and autism have similaritiesH Crom my own eperience I would like to suggest a possi$le answer. !uditory and tactile input often overwhelmed me. +oud noise hurt my ears. Ehen noise and sensory over stimulation $ecame too intense I was a$le to shut off my hearing and retreat into my own world. Possi$ly the autistic child creates his or her own self-imposed sensory deprivation. In pulling away I may not have received stimulation that was required for normal development. Possi$ly there are secondary central nervous system a$normalities that happen as a result of the autistic child3s avoidance of input. (he initial sensory processing a$normalities that the child is $orn with cause the initial avoidance. !utopsy studies indicate that cere$ellar a$normalities occur $efore $irth ?auman 1881 ?auman and @emper 1884;. 6owever the lim$ic system which also has a$normalities is not mature until the child is two years old. (he possi$ility of secondary damage to the central nervous system may eplain why young children in early intervention education programs have a $etter prognosis than children who do not receive special treatment. !nimal and human studies show that restriction of sensory input causes the central nervous system to $ecome overly sensitive to stimulation. (he effects of early sensory restriction are often long lasting. Placement of a small cup on a person3s forearm for one week to $lock tactile sensations will cause the corresponding area on the opposite arm to $ecome more sensitive !ftanas and u$eck 18A4;. Puppies reared in $arren kennels $ecome hyperecita$le and their $rain waves &&5; still showed signs of over arousal si months after removal from the kennel *el,ack and ?urns 18A:;. (he $rain waves of autistic children also show signs of high arousal 6utt et al. 18A:;. (rimming the whiskers on $a$y rats will cause the parts of the $rain that receive input from the whiskers to $ecome oversensitive "imon and +and 1897;. (his a$normality is relatively permanent. (he $rain areas were still a$normal after the whiskers had grown $ack. Perhaps it would $e $eneficial if autistic $a$ies were gently stroked and /tamed/ when they stiffen and pull away. I often wonder if I had received more tactile stimulation as a child if I would have $een less /nervous/ as an adult. 6andling $a$y rats produces calmer adults which are more willing to eplore a ma,e enen$erg et al. 18A2G &hrlich 18:8;. (actile stimulation is vital for $a$ies and aids in their development. (HAT IS #ISUAL THINKING.
(hinking in language and words is alien to me. I think totally in pictures. It is like playing different tapes in a video cassette recorder in my imagination. I used to think that every$ody thought in pictures until I questioned many different people a$out their thinking processes. I have conducted an informal little cognitive test on many people. (hey are asked to access their memory of church steeples or cats. !n o$)ect that is not in the person3s immediate surroundings should $e used for this visuali,ation procedure. Ehen I do this I see in my imagination a series of /videos/ of different churches or cats I have seen or known. *any /normal/ people will see a visual image of a cat $ut it is a sort of generali,ed generic cat image. (hey usually don3t see a series of vivid cat or church /videos/ unless they are an artist parent of an autistic child or an engineer. *y /cat/ concept consists of a series of /videos/ of cats I have known. (here is no generali,ed cat. If I keep thinking a$out cats or churches I can manipulate the /video/ images. I can put snow on the church roof and imagine what the church grounds look like during the different seasons.
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"ome people access their /cat/ knowledge as auditory or written language. Cor me there is no language $ased information in my memory. (o access spoken information I replay a /video/ of the person talking. (here are some $rilliant people who have little visual thought. ne totally ver$al professor told me that facts )ust come to his mind instantly with no visual image. (o retrieve facts I have to read them off a visuali,ed page of a $ook or /replay the video/ of some previous event. (his method of thinking is slower. It takes time to /play/ the videotape in my imagination. esearch findings indicate that ver$al thought and visual thinking work via different $rain systems Carah 1898G eki 1882;. "tudies of patients with $rain damage indicate that one system can $e damaged while another system may $e normal. (he $rain is designed with modular systems. (hese systems may work either together or separately to perform different tasks. Cor eample people with certain types of $rain damage can recogni,e o$)ects with straight edges $ut they cannot recogni,e o$)ects with irregular edges. (he $rain module that recogni,es irregular shapes has $een damaged Eeiss 1898;. In autism the systems that process visual-spatial pro$lems are intact. (here is a possi$ility that these systems may $e epanded to compensate for deficits in language. (he nervous system has remarka$le plasticityG one part can take over and compensate for de ficits in language. (he nervous system has remarka$le plasticityG one part can take over and compensate for a damaged part 6uttenlocher 1894;. ! functional *I study $y ing et al. 1888; indicates that people with autism depend more on the visual parts of the $rain on an em$edded figures test. U1in6 #i1:alia7in
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Intellectual giftedness is common in the family histories of many persons with autism. In my own family history my great grandfather on my father3s side was a pioneer who started the largest corporate wheat farm in the world. ne sister is dysleic and is $rilliant in the art of decorating houses. Ehen I think a$out a$stract concepts such as relationships with people I use visual images such as a sliding glass door. elationships must $e approached gently $ecause $arging forward too quickly may shatter the door. (hinking a$out the door was not enoughG I had to actually walk through it. Ehen I was in high school and college I had actual physical doors that sym$oli,ed ma)or changes in my life such as graduations. !t night I clim$ed through a trap door on the roof of the dormitory to sit on the roof and think a$out life after college. (he trap door sym$oli,ed graduation. (he doors were a visual language for epressing ideas that are usually ver$ali,ed. Park and =ouderian 1874; also report use of visual sym$ols such as doors to descri$e a$stract concepts.
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COMMUNICATION
I screamed $ecause it was the only way I could communicate. Ehen adults spoke directly to me I could understand everything they said. Ehen adults talked among themselves it sounded like gi$$erish. I had the words I wanted to say in my mind $ut I )ust could not get them outG it was like a $ig stutter. Ehen my mother wanted me to do something I often screamed. If something $othered me I screamed. (his was the only way I could epress my displeasure. If I did not want to wear a hat the only way I could communicate my desire not to wear the hat was to throw it on the floor and scream. ?eing una$le to talk was utter frustration. I screamed every time my teacher pointed the pointer towards me. I was afraid $ecause I had $een taught at home never to point a sharp o$)ect at a person. I feared that the pointer would poke out my eye. (he speech therapist had to put me in a slight stress state so I could get the words out. "he would gently hold me $y the chin and make me look at her and then ask me to make certain sounds. "he knew )ust how much to intrude. If she pushed too hard I would have a tantrumG if she did not push enough there was no progress. uring recent visits to autism programs I have o$served this technique $eing used in many different types of programs. Ehen I started to speak my words were stressed with an emphasis on vowel sounds. Cor eample /$ah/ for $all. *y speech therapist stretched out the hard consonant sounds to help my $rain to perceive them. "he would hold up a cup and say Jccc u ppp.K
Ehat is the difference $etween P Pervasive evelopmental isa$ility; !utism !sperger3s "yndrome etc.H It is dou$tful that there are $lack and white $oundaries $etween the different diagnostic categories. It is likely that there is a continuum where each diagnostic category merges into the net one in many varied shades of gray. &ven though the different types of autism are on a continuum the characteristics of the different types can $e different. It is well known that different types of autism respond differently to various drugs. Crom a treatment standpoint they are apples and oranges $ut from a neurological standpoint the differences may $e less distinct. (he different su$types of autism may also differ from an emotional standpoint as well. !s one moves from one end of the su$types spectrum to the other emotions may vary from a lack of affect to more normal emotions. uring talks with hundreds of parents and reading in scientific literature I have divided autism diagnosis into two $road categoriesD 1; @anner'!sperger (ypes named after the doctors who discovered autism; @anner 184 and !sperger 1844; and 2; the &pileptic'egressive (ypes. Cragile L etts "yndrome known fetal damage and damage due to high fevers are not included. ?oth types pro$a$ly have a strong genetic $asis. (alks with parents indicate that they $oth have the same family history profile 5randin 1882a;. !n interview with *argaret ?auman indicated that $oth types have the same pattern of $rain a$normalities ?auman 1881 and ?auman and @emper 1884;. uring her autopsy studies she eamined $oth types. Possi$ly the different clinical symptoms $etween the two types can $e eplained in su$tle variations of $rain a$normality within the larger framework of a $asic a$normality in the lim$ic system hippocampus amygdala and cere$ellum.
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KannerA1per6er T0pe
!sperger3s "yndrome is pro$a$ly a milder type of traditional @anner type high- functioning autism. People with !sperger3s syndrome can often function $etter in the community and have more normal speech and thinking patterns. esearch $y ?owler et al. 1882; at the #niversity of +ondon indicates that they can solve a simple /(heory of *ind/ pro$lem that traditional high-functioning autistics fail. !n eample of (heory of *ind pro$lem isD /Peter thinks that >ane thinks etc./ ?oth the @anner and !sperger types have deficits in flei$le pro$lem solving facial recognition and fine motor speed coordination. (esting at the #niversity of enver $y ,onoff et al. 1881; indicates that $oth types do poorly on the Eisconsin %ard "orting (est which is a test of flei$le pro$lem solving. *ost people with autism are visual thinkers $ut there are some people with !sperger3s syndrome who are good with num$ers and have poor visual skills. @anner'!sperger types can range from individuals with rigid thinking patterns and a relatively calm temperament to people with more normal thinking patterns with lots of aniety and sensory sensitivity pro$lems. *any of the individuals have flat affect. %harlie 6art3s 1898; ecellent $ook
!t pu$erty I had severe pro$lems with aniety nervousness and sensitivity to touch and sound. (he aniety felt like a constant state of stage fright for no reason. n the worst days I felt like I was $eing stalked $y a gunman. Proper use of the right medication changed my life. *y speech $ecame more modulated and I $ecame more social when the aniety eased. (he individuals with aniety and nervousness pro$lems are likely to respond well to small doses of antidepressant drugs such as clomipramine *cougal et al. 1882 and 5ordon et al. 188; and fluoetine %ook et al. 1882;. +ow doses of antidepressant drugs must $e used to prevent pro$lems with agitation and irrita$ility. "everal papers I have read on the use of antidepressants in autism have stated that the $eneficial effect of the drug wore off in several weeks or months. Ehen the dose was raised there were pro$lems with insomnia restlessness and agitation. (hese side effects are caused $y an overdose of the antidepressantG and if they occur the dose must $e immediately lowered. I have $een on the same low dose for twenty years. Ehen I first stated taking antidepressants the effect wore off in four months and the aniety returned. I remained on the same dose and the drug started to work again several weeks later. If the effect of an antidepressant appears to wear off and aniety or $ad $ehaviors returns do not raise the dose. emain on the same dose and the antidepressant will usually start working again after the relapse period passes. Cind the lowest dose that works effectively and 0&<& raise it. Cluoetine is recommended if the &&5 shows a$normalities $ecause it is less likely to cause an epileptic sei,ure. !nother advantage of fluoetine is it has fewer uncomforta$le side effects. !necdotal reports from other adults with autism indicate that fluoetine improved their lives. Cluoetine and other antidepressants should $e used very sparingly in children. (he use of powerful medications in young children is a controversial area. *edications given when the $rain is developing may possi$ly have a permanent effect on the development of neurotransmitter systems. "ome medications may $e very harmful $ut there is also a possi$ility that some may $e $eneficial. ne must always $alance risk versus $enefit. ! good rule of thum$ is that a medication should have an o$vious fairly dramatic effect. esearch has shown that very young autistic children have a$normally low levels of serotonin in their $rain compared to normal children %hugani et al. 1888;. *edications such as fluoetine and other serotonin reuptake inhi$itors will increase serotonin levels in the $rain. *ay$e this would $e good for the young autistic $rain. at research has now shown that fluoetine may promote the development of serotonin circuits in the $rain Eegerer et al. 1888;. !t this time no$ody knows if fluoetine is good or $ad for young autistic children. Re6re11i
(hese individuals often have more o$vious neurological pro$lems and their a$ility to understand speech is often poor. &ven though they may pass a standard pure tone hearing
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test they may not $e a$le to hear comple speech sounds. "ome of them cannot follow a simple command like /put the $ook on your head./ aselskis et al. 188;. ?oth report that clonidine is $eneficial for $ehavior pro$lems. ecently there has $een a concern a$out the safety of clonidine in children. r. &d %ook reports that clonidine wears off in several months if it is given continually. 6e recommends using it only when needed to help a child or an adult sleep and not giving it during the day. ne must always $alance risk versus $enefit. ?oth reports from parents and a report $y icketts 188; indicate that fluoetine is useful for reducing self-in)ury. "erious $ehavior pro$lems sometimes occur at pu$erty and autistic teenagers and adults may have severe rage or aggression. ?eta $lockers such as propranolol are effective for reducing severe aggression in adults atey et al. 1897;. r. atey has also found that risperidone will control aggression and rages which may not respond to other medications. r. >oe 6uggins has $een working for years with teenagers and adults to find effective medication regimes for very severe aggression and rage. r. 6uggins reports that risperidone must $e give in very low doses to $e most effective. (his medication affects $oth the serotonin and dopamine systems in the $rain.
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are doing very well on a single ""I such as Pro,ac fluoetine;. r. 6uggins has also reported that a com$ination of a reduced sugar diet and propranolol was more effective than propranolol alone. r. 6uggins pu$lications can $e ordered $y calling 41A-448-::11 or 41A-44:-F2 also www.?itemarks.com;. 6is spiral $ound $ooklet titled Niagnostic and (reatment *odel for *anaging "I? age and other 6yperadrenergic ?ehaviors in the !utistic P and Populations3 can $e o$tained $y contactingD @erry3s Place 4 ?erc,y "t. "uite 18F !urora ntario %anada +45 1E8G CaD 8F:-941-14A1. ut$ursts of aggression in autistic teenagers and adults are sometimes caused $y frontal or temporal lo$e sei,ures. (hese sei,ures epileptic episodes; are often difficult to detect on an &&5 5edye 1898 1881;. "ei,ures should $e suspected if the rages occur totally at random. *ost other types of aggression or rage are usually triggered $y some event such as frustration with communication painful sensory stimuli or an unepected change in routine. If epilepsy is suspected the teenager may respond positively to either car$ama,epine valproic acid or divalproe sodium 5edye et al. 1898 1881;. %alcium supplements may help prevent severe self-a$use such as eye gouging %oleman 1884;. Ehen a medication is used careful o$servations should $e made to determine if it is really effective. !s I stated $efore one must $alance the risk against the $enefit. (o avoid dangerous drug interactions consult consult 5raedon and 5raedon 188:;. 5rapefruit )uice should $e avoided. It interacts $adly with certain medications. ne must ask the questionD oes this medication provide sufficient $enefit to make it worth the riskH In a nonver$al individual a careful medical eamination is recommended to look for hidden painful medical pro$lems which could $e causing either self-in)ury or aggression. +ook for ear infections tooth aches digestive pro$lems headaches and sinus pro$lems. EDUCATIONAL STRATEGIES AND SU!TYPES
! teaching and therapy program that worked well for me may $e painful and confusing to some nonver$al lower functioning regressive'epileptic people with autism. *y speech therapist forced me to look at her. I needed to $e )erked out of my autistic world and kept engaged. "ome children with more severe sensory pro$lems may withdraw further $ecause the intrusion completely overloads their immature nervous system. (hey will often respond $est to gentler teaching methods such as whispering softly to the child in a room free of florescent lights and visual distractions. onna Eilliams 1884; eplained that forced eye contact caused her $rain to shut down. "he states when people spoke to her /their words $ecome a mum$le )um$le their voices a pattern of sounds/ Painter 1882;. "he can use only one sensory channel at a time. If onna is listening to some$ody talk she is una$le to perceive a cat )umping up on her lap. If she attends to the cat then speech perception is $locked. "he reali,ed a $lack thing was on her lap $ut she did not recogni,e it as a cat until she stopped listening to her friend talk. "he eplained that if she listens to the intonation of speech she can3t hear the words. nly one aspect of incoming input can $e attended to at a time. If she is distracted $y the visual input of some$ody looking in her face she can3t hear them. ther people with autism have eplained that they had a difficult time determining that speech was used for communication. @ins a man with autism further eplained that if some$ody looked him in the eye /*y mind went $lank and thoughts stopG it was like a twilight state./ %esaroni and 5ar$er 1881; also descri$e confusing and miing of sensory channels. >im a man with autism eplained /"ometimes the channels get confused as when sounds came through as color./ 6e also said that touching the lower part of his face caused a sound- like sensation. onna told me that she sometimes has difficulty determining where her $ody $oundary is. %esaroni and 5ar$er 1881; also noted pro$lems with locating a tactile stimulus. (he tendency of some autistic people to constantly touch themselves and o$)ects around them may $e an attempt to sta$ili,e $ody and environmental $oundaries. (herese >oliffe an autistic woman eplained that it was easier to learn $y touch $ecause touch was her most accurate sense >oliffe et al. 1882;. onna told me that sensory integration treatment consisting of ru$$ing her skin with $rushes has helped. &ven though she disliked the tactile input from the $rushes she reported that it helped her
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different sensory systems to work together and $ecome more integrated. 6er sensory processing also $ecomes more normal when she is relaed and is focusing on only one sensory channel. onna may $e half way along the continuum $etween the @anner'!sperger (ype and the egressive &pileptic (ype. Pa77ern1 ; Ne:rl6i9al A2nrmali7ie1
?oth @anner'!sperger (ypes and the egressive'&pileptic (ypes have a$normalities of the cere$ellum ?auman 1881 ?auman and @emper 1884;. %ere$ellar a$normalities may eplain the sound and touch sensitivity pro$lems o$served in most forms of autism. esearch on rats indicates that the vermis of the cere$ellum modulates sensory input %rispino and ?ullock 1894;. "timulation of the cere$ellum with an electrode will make a cat hypersensitive to $oth sound and touch %ham$ers 1847;. (he cere$ellum may act as a volume control for hearing vision and touch. %ourchesne et al. 1899; found that many high-functioning @anner'!sperger autistic people have a$normalities of the cere$ellar vermis. @anner'!sperger (ypes may also have a smaller than normal cere$ellum. *I scans of my own $rain indicated my cere$ellum is 2F percent smaller than normalG and an autistic computer genius with ultra classical @anner (ype autism has a cere$ellum that is F percent smaller than normal. !s discussed previously the more severely impaired egressive'&pileptic (ype autistic people have much greater sensory processing pro$lems. *ost @anner'!sperger (ypes do not eperience sensory )um$ling and they can attend to simultaneous visual and auditory input. In more severe cases such as Eilliams 188; and %esaroni and 5ar$er 1881; sensations from the eyes and ears can mi together. Individuals with autism process information very slowly and they must $e given time to respond. 0onver$al adults will process sensory input more slowly than ver$al adults. "ome individuals with very severe sensory processing pro$lems may take several hours to recover after eperiencing sensory overload. 5illingham 188:; contains an ecellent review of autistic sensory pro$lems. Parents often ask Ohow can I tell how severe my childs sensory pro$lems areH %hildren and adults that have tantrums every time they go in a large supermarket or shopping mall usually have severe sensory processing pro$lems. %hildren and adults who en)oy shopping in $ig stores usually have less severe sensory pro$lems. (he degree of sensory processing pro$lems will vary greatly from case to case. It can vary from mild sound sensitivity to sensory )um$ling and miing. +ewis 188; descri$es her son who may $e mid-way $etween @anner (ype and egressive'&pileptic (ype. 6e does not have the rigid thinking of a typical @anner (ype and he understands the give and take of conversations. 6owever he has signs o f serious sensory processing pro$lems $ecause he does self-stimulatory $ehaviors in nearly every sensory modality. Possi$ly this may $e due to $rain stem a$normalities in addition to the cere$ellar a$normalities. 6ashimoto et al. 1882; found that low-functioning autistic people with low IM scores had smaller $rain stems. *c%lelland et al. 1882; also found that low-functioning individuals were more likely to have a$normal results on a central conduction time test which is a measure of $rain stem function. *c%lelland et al. 1882; $elieve that autistic people have a defect in myelini,ation. (his would account for the frequent occurrence of epilepsy and a$normal $rain stem- evoked potentials in older autistic children. *yelin forms the fatty sheaths around neurons. It is like insulation on electrical wires. (he lack of myelini,ation may also account for the miing of sensory input from the eyes and ears and mind $lank outs that occur when an autistic person $ecomes ecited. (he /space out/ and )um$ling may $e due to miniature epileptic sei,ures that occur $etween the poorly myelinated neurons. >im one of the autistic people that %esaroni and 5ar$er 1881; interviewed theori,es that certain frightening sounds can act as a trigger for disorgani,ation of processing similar to epileptic sei,ures that a flashing light can trigger. CAUSE OF AUTISM
!utism is a neurological disorder that is not a result of psychological factors. ! comple inheritance of many interacting genetic factors cause most cases of autism. (here is a continuum from normal to a$normal. !utistic traits often show up in a mild degree in the parents si$lings and close relatives of an autistic child 0arayan et al. 188FG +anda et al.
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1882;. "ome of the traits that seemed to $e associated with autism areD intellectual prowess shyness learning disa$ilities depression aniety panic attacks (ourettes tic disorder; and alcoholism 0arayan et al. 188FG "verd 1881;. (here is a high correlation $etween !sperger3s syndrome and manic depression elong and yer 1899;. Possi$ly a small amount of these genetic traits confers an advantage such as high intelligence or creativityG too many of the traits will cause pro$lems %lark 188; ther causes of autism are the Cragile L gene insults to the fetus such as u$ella or other viruses and high fevers at a young age. ?rain autopsy research ?auman 1881 ?auman and @emper 1884; and *I studies %ourchesne et al. 1899G 6ashimoto et al. 1882; indicate that people with autism have structural a$normalities in the $rain. %ertain areas of the $rain such as the lim$ic system and cere$ellum are immature. ther studies have shown that lower functioning people with autism also have a$normally slow transmission of nerve impulses through the $rain stem *c%lelland et al. 188; and immature &&5 patterns %antor et al. 189A;. r. Patricia odier 2FFF; eplains that the $rain a$normalities that cause autism occur very early in the developing em$ryo. 6er research has shown that there are defects in the developing $rain stem that happened near the end of the first month of pregnancy. ! structure called Othe superior olive is missing in the $rain stem. (his may eplain the lack of cere$ellum development in autism. In summary autism is a disorder in which some parts of the $rain are underdeveloped and other parts may $e overdeveloped. (his may $e a possi$le eplanation for why some autistic people have enhanced visual and savant skills. CONCLUSIONS
(eachers therapists and other professionals who work with autistic people need to recogni,e and treat sensory processing pro$lems in autism. (reatment programs that are appropriate and $eneficial for one type of autism may $e painful for other types. !t ages two to four many autistic children will pro$a$ly respond well to gently intrusive programs where the child is required to maintain eye contact with the teacher. +ovaas 1897; has documented that roughly half of young children will improve sufficiently so they can $e enrolled in a normal first grade at age si or seven. It is likely that the children who did not improve in the +ovaas program were eperiencing sensory overload. (hey may respond $etter to a gentler approach using only one sensory channel at a time. !s children get older they tend to separate into two groups. %hildren like me who can $e /)erked/ out of the autistic world and asked to pay attention and individuals like onna Eilliams and (herese >oliffe who require a gentler approach. (he prognosis of $oth types of children will $e improved if they receive a minimum of 2F hours a week of good educational programming $etween the ages of two and five. ?oth types of young autistic children *#"( $e prevented from shutting out the world. (hey have to $e kept engaged so that their $rains can develop more normally. Cor one type of child the teacher can /)erk open the front doorG/ and for the other type the teacher must /sneak quietly through the $ack door./
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Ta2le , Autism Subtypes
(hese su$types are on a continuum that merges together. Information in the ta$le is $ased on scientific literature and interviews with autistic people teachers and parents. /------------------------------\ | | | Kanner/Asperger Type | | (High Functioning) | | | | | \------------------------------/
#$ %o o&vious 'otor pro&le's &ut so'e Asperger Types ten* to &e clu'sy$
+$ Have receptive speech an* can un*erstan* "hat is sai* to the' (.ran*in #0)$ 1any chil*ren "ith partial receptive speech are echolaic$ They repeat phrases &ecause they only hear parts o the'$
8$ ensory over-sensitivity to soun* touch or visual sti'uli (.ran*in an* cariano #09 .ran*in #+ #;9 tehli ##9 5ol4'ar an* 6ohen #;9
>$ el*o' have epileptic sei?ures an* EE. rea*ings are usually nor'al &ut 'ay have cere&ellar a&nor'alities (6ourchesne et al$ #9
;$ Rigi* concrete thin4ing no co''on sense an* lac4 o aect (Kanner #>89 Asperger #>>9 Hart #9
/---------------------------------\ | | | Regressive/Epileptic Type | | (Oten !o" Functioning) | | | | | \---------------------------------/
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
#$ o'eti'es have o&vious &o*y 'ove'ent pro&le's or *iiculty "ith stopping an* starting han* 'ove'ents$ +$ %o receptive speech (Allen an* ,ain #+) or inco'ing speech soun*s 'ay a*e in an* out$ 2n severe cases inco'ing speech 'ay &e a 3u'&le o soun*$ 1ore li4ely to &e 'ute (5ol4'ar an* 6ohen #)$ 1ay have *iiculty *eter'ining speech is use* to co''unicate (7olie #+)$ 8$ ensory inor'ation ro' the *ierent senses 'y 3u'&le an* 'i: together into noise or patterns (an*s an* Ratey #09 6esaroni an* .ar&er ##9 ,ainter #+)$ 5ery slo" sensory processing (.illingha' #;)$ 1ay learn &est &y touch$ .ive the' letters an* o&3ects to eel$ >$ Oten have epileptic sei?ures a&nor'al EE. rea*ings un*ersi?e* &rain ste's an* i''ature central nervous syste' *evelop'ent (.e*ye ##9 Hashi'oto et al$ #+9 1c6lellan* et al$ #+9 9 6anter et al$ #0)$ ;$ 1ay have 'ore nor'al thin4ing an* e'otions (6esaroni an* .ar&er ##9 @illia's #+ #>)$
0$ Respon* poorly to intrusive 'etho*s *ue to sensory overloa* (@illia's #8)$ @hen they &eco'e stresse* or oversti'ulate* inco'ing sti'uli &eco'es 3u'&le* an* 'i:e* together$ 2ntrusive
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#8)$
| | | | =$ Arai* o certain noises &e| cause they hurt the ears &ut | 'ay &e attracte* to other soun*s | an* visual sti'uli such au| to'atic sli*ing *oors or lush| ing the toilet$ | | | | | | | $ o'e in*ivi*uals 'ay have | severe an:iety pro&le's (.ran*in | #09 #+l #;9 5ol4'ar an* | 6ohen #;) "hile others are | cal' (Hart #=)$ | | $ Teenagers an* a*ults oten | respon* to lo" *oses o anti| *epressant *rugs such as clo'i| pra'ine an* luo:etine$ 6lo'i| pra'ine is the reco''en*e* irst | choice i the in*ivi*ual has | severe o&sessive-co'pulsive | sy'pto's$ Fluo:etine has e"er | unco'orta&le si*e eects an* is | preerre* &y 'any in*ivi*uals$ | These 'e*ications are usually not | reco''en*e* in chil*ren unless | there is a severe &ehavior pro&le' | that *oes not respon* to sensory | or &ehavioral interventions$ |
teaching 'etho*s that "or4 "ith young Kanner/Asperger chil*ren 'ay cause conusion an* pain$ =$ 1ay &e a&le to atten* to only one sensory channel at a ti'e$ Buring teaching *istractions shoul* &e 'ini'i?e* an* inor'ation shoul* &e presente* to only one sensory 'o*ality (6esaroni an* .ar&er ##9 @illia's #8)$ @ill actively avoi* soun*s an* sti'uli that 'ay &e attractive to less severely alicte* in*ivi*uals$ $ o'e in*ivi*uals have severe an:iety pro&le's$
$ Teenagers an* a*ults "ith rage an* aggression ten* to respon* &est to in*eral cloni*ine luo:etine an* &uspirone$ Epilepsy 'e*ications such as car&a'a?epine an* valproic aci* are also helpul$ 2n chil*ren <0 an* 'agnesiu' an* B1. are so'eti'es helpul$ 2 speech ails to *evelop &y age our ethosu:i'i*e or valproic aci* 'ay helpul$ (,liophys #> .ill&erg ##)$
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M0 Mind i1 a (e2 !r41er H4 Peple 4i78 A:7i1m T8in5 $y (emple 5randin %ere$rum 2FFF Einter
(he struggle that made possi$le (emple 5randin3s early development graduate education and nota$le career as a professor of animal $ehavior designer of animal facilities worldwide and cele$rated writer speaker and researcher on autism is told in her $ooks &mergenceD +a$eled !utistic 189A; and (hinking in Pictures and ther eports Crom *y +ife Eith !utism Q
M0 mind i1 a (e2 2r41er 0ow let me eplain how the language part of my $rain and the /thinking in pictures/ part of my $rain seem to interact. *y mind works )ust like an Internet Ee$ $rowser. ! Ee$ $rowser finds specific wordsG $y analogy my mind looks for picture memories that are associated with
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a word. It can also go off on a tangent in the same way as a Ee$ $rowser $ecause visual thinking is non-linear associative thinking. (o demonstrate how my mind works at an autism meeting I asked a mem$er of the audience to name a thing for me to invent. I wanted to show how the visual part of my $rain and the language language part worked separately. separately. "ome$ody said /invent a $etter paper clip./ (he language language part of my $rain said /I can do that/ and pictures immediately started flashing into my imagination of all kinds of paper clips I have seen. *y /Ee$ $rowser/ searched the picture memory filesG many paper clip pictures flashed through my imagination like slides. I could stop on any one picture and study it. I saw an odd plastic paper clip that was on a scientific paper from &urope. !t this point I got off the su$)ect and saw pictures of the first scientific meeting I had attended in "pain. (he language voice inside me said /5et $ack on the su$)ect of paper clips./ (he language part of me is a manager who uses simple non-descriptive language to tell the rest of my $rain what to do. ften the $est ideas for inventing things come )ust as I am drifting off to sleep. (he pictures are clearer then. It is as though I can access the most concrete vivid memory files with the most detailed images. (he language part of my $rain is completely shut off at night. (o get ideas for new paper clip designs I can pull up pictures of clothes pins and other clip-like things such as mouse traps and % clamps used in woodworking. I start thinking that inventing a $etter clip for holding a thick pile of papers together might might $e more marketa$le marketa$le than a new paper clip design. &isting spring $inder clips tend to rip envelopes when papers are mailed $ecause the clips have protruding edges. Ehen I think a$out this I see ripped envelopes. (he language part of my mind says /esign a flat $inder clip for thick documents./ Ehen I say this I see a mailed document in an undamaged envelope. *y visual imagination then sees a large plastic clip that I saw in >apan. >apanese apartment dwellers who do not have clothes dryers use large plastic clips to hold $lankets and other laundry on $alcony railings. ! small version of the >apanese $alcony clip may make a $etter paper clip for holding many pages. Ehen I was responding to the paper clip inquiry I knew that I could visually associate all day a$out paper clips. (he language part of my mind then said /(hat is enough/ and I resumed my lecture. ?ut as I corrected the first draft of this article I saw a one-piece molded plastic $inder clip that would lay flat on a thick $unch of papers. I do have the a$ility to control the rate at which pictures come onto the /computer screen/ in my imagination. "ome people with autism are not a$le to do this. ne person with autism told me that images eplode into a we$ of a pictures that are interrelated. (he decision-making process can $ecome /locked up/ and over-loaded with pictures coming in all at once.
Unma15in6 Talen7 I have $een fascinated with research indicating that the detailed realistic pictures that autistic savants -- autistic individuals with etraordinary talent in a specific area -- make may $e create created d $y direct directly ly access accessing ing primar primary y memory memory areas areas deep in the $rain. $rain. esear esearch chers ers in !ustra !ustralia lia hypoth hypothesi esi,e ,e that that autist autistic ic savant savants s may have have privil privilege eged d access access to lower lower levels levels of information. ! study with a non-autistic /human calculator/ who could solve multiplication pro$lems twice as quickly as a normal person indicated that his $rain had enhanced low-level processing.4 &&5 recordings of his $rain waves showed that $rain activity was greatest as compared with a normal person when the multiplication pro$lem was first flashed on the screen. I hypothesi,e that I am a$le to access primary visual files in my $rain. Ehen designing live livest stoc ock k equip equipme ment nt in my $usi $usine ness ss I can can do three three-d -dim imen ensi sion onal al full full moti motion on vide videos os of equipment and can test-run the equipment in my imagination. I can walk around it or fly over it. *y a$ility to rotate the image is slow. I move my mind3s eye around or over the image. Ehen I read an article in 0eurology a$out frontal temporal lo$e dementia I $ecame etremely ecited. It provided a scientific foundation for the idea of hidden visual thinking under a layer of ver$al thinking. thinking. esearch esearch on frontal frontal temporal temporal lo$e dementia dementia an !l,heimer3s !l,heimer3s-lik -like e condition condition that destroys language and social areas in the $rain demonstrated that as the condition progressed visual skills in art emerged in people who had no interest in art. (he increase in creativity was always visual never ver$al. ?rain scans found the highest activity in the visual
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corte. !s the patient3s cognitive a$ilities deteriorated the art $ecame more photo realistic. !rtwork pu$lished with the )ournal article looks like the art of autistic savants.
I 1ee 78e de9i1in pr9e11 I see the decision-making process in my mind in a way most people do not. Ehen I tried to eplain this to a person who thinks in language he )ust didn3t get it. 6ow my decision-making works is most clearly seen in an emergency. n a $right sunny day I was driving to the airport when an elk ran into the highway )ust ahead of my car. I had only three or four seconds to react. uring those few seconds I saw images of my choices. (he first image was of a car rear ending me. (his is what would have happened if I had made the instinctive panic response and slammed on the $rakes. (he second image image was of an elk smashing smashing through my windshield windshield.. (his is what would have happened if I had swerved. (he last image showed the elk passing $y in front of my car. (he last choice was the one I could make if I inhi$ited the panic response and $raked )ust a little to slow the car. I mentally /clicked/ on slowing down and avoided an accident. It was like clicking a computer mouse on the desired picture.
Animal de9i1in ma5in6 I speculate that the decision-making process I used to avoid the accident may $e similar to the process animals use. Crom my work with animals I3ve come to $elieve that consciousness originally arose from the orienting response. Ehen a deer sees a person it will often free,e and look at him. (his is the deer3s orienting response. uring this time it decides either to run away or to keep gra,ing. It does not act as a programmed ro$ot governed $y instinct or refleesG it has the flei$ility to make a decision. ne of the things that has helped me to unders understan tand d animal animals s is that that more more than than most most people people I think think and feel like like one. one. (he more /anima /animal/ l/ parts parts of the normal normal human $rain may $e covered covered $y layers layers of langua language-$ ge-$ase ased d thinking.
T8in5in6 in a:di 7ape1 In connection with my lectures I have talked with autistic people who are not visual thinkers. (hey seem to think in audio tape clips. !udio tape thinking does not have to involve languageG instead of using visual images to form memories these people store very specific audio clips. I suspect that for them hearing is easier than seeing. r. >ohn "tein and his colleagues at ford #niversity have discovered that some people have difficulty seeing rapidly changing visual scenes. (hey find reading is difficult $ecause the print appears )um$led. A (his results from defects in $rain circuits that process motion. 7 (he eye is fineG the circuits circuits $etween $rain and eyes malfunction. ne person I know who is epert at training animals told me that she hears the animal3s $ehavior instead of seeing it. "he has audio tapes in her memory with little sound details. Cor eample she knows that the animal is relaed or agitated $y listening to its $reathing or footsteps. "he reads audio signals instead of $o dy posture.
Pie9in6 78e de7ail1 76e78er People with autism and animals as well pay more attention to details. !s I descri$ed in Thin=ing in #ictures all my thinking goes from the specific to the general. I look at lots of little details and piece them together to make a concept. (he first step in forming an idea is to make categories. Cor eample the most primary level is sorting o$)ects $y color or shape. (he net step is sorting things $y less o$vious features features as when we categori,e cats and dogs. Ehen I was five years old I figured out that a miniature dachshund was not a cat $ecause it had a dog3s noseG all dogs had certain features that were visually recogni,a$le. *y mind seeks these categories amidst an array of little details. In pro$lem solving my thinking process is like that of an epidemiologist tracking down a disease. (he epidemiologist collects lots of little pieces of information and finally figures out the common factor that caused
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certain people to fall ill. Cor eample they may all have eaten straw$erries from a certain place. !lso I understand concepts visually. Cor eample all o$)ects classified as keys will open locks. I reali,e that the word /key/ can also $e used metaphorically when we say /the key to success is positive thinking./ Ehen I think a$out that phrase I see 0orman
Di17:r2in6 1:nd1 I have always felt that my senses were more like those of an animal. oes my $rain have deeper access to the ancient anti-predator circuits that humans share with animalsH !t night I cannot get to sleep if I hear high-pitched intermittent noise such as a $ackup alarm on a truck or children yelling in the net hotel roomG they make my heart race. (hunder or airport noise does not $other me $ut the little high-pitched noises cannot $e shut out. ecent research with pigs has confirmed that intermittent sounds are more distur$ing to them than steady sounds. 8 Ehy are high-pitched sounds distur$ing to animals and to me; while airport noises and thunder are notH I speculate that in nature the rum$le of thunder is not dangerous $ut a highpitched noise would $e an animal3s distress call. ?eeping $ackup alarms and car alarms are electronic distress calls which activate my nervous system even though I know they are harmless. It is almost as though these animal circuits in my $rain have $een laid $are.
Prpr7inal 78in5in6 ! recent report in "cience indicated that activities involving num$ers are processed in at least two different parts of the $rain. 1F Precise calculations are dependent on language and are processed in the frontal areasG proportional figuring is processed in visual areas. Proportional thinking is figuring out if one o$)ect is less or more than another. Cor eample three mar$les are more than one mar$le. !nimals can do proportional thinking. (hey can easily determine
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that 1F pieces of food are more than two. It is likely that proportional thinking is the kind of num$er processing that humans share with animals. In school math was a tough su$)ect for me. Cinding the precisely correct answer is difficult $ecause I mi up num$ers. n the other hand I am very good at proportional thinking coming up with an accurate approimate answer. In my scientific work I often convert numerical differences $etween my control and eperimental groups to percentage differences. Percentage differences can $e visuali,ed on a pie chart. Ehen I present data I like to use charts and graphs so I can see the proportional differences $etween different sets of data. Ehen I did cost estimating for cattle industry construction pro)ects I never tried to calculate pro)ects to the penny. Instead I estimated the cost of a new )o$ $y figuring out its proportional cost in relation to other finished pro)ects. (his was mainly a visual process. I would look at the drawing and $uild the entire pro)ect in my imagination. I then would put it up on the video screen in my imagination and compare it in si,e to other completed pro)ects that had complete cost figures. In my mind I could compare four or five completed pro)ects with the drawing I was estimating. (he pro)ect $eing estimated might $e equal to two-thirds of a cattle-handling facility that I designed at ed iver Ceedlot and a$out 2: percent $igger than a corral I designed for +one *ountain anch. Cor money to have meaning to me it must $e related to something I can $uy with it otherwise it is too a$stract. Cor eample R is equal to lunch at *conald3s R2F is a tank of gas and R1FFF can $uy a computer. ?ig ta$les full of figures make little sense to me. "ome more severely autistic people do not understand money at all. Cor me to understand a $illion dollars I have to have a picture in my mind of something that cost a $illion dollars. ne $illion is one quarter of the cost of the new enver !irport. Ehen President %linton announced part way through the war in @osovo that it had cost R2 $illion I figured that half a enver !irport worth of money had $een spent. ifferent amounts of money have different visual values. It is interesting that proportional thinking for num$ers is in the visual parts of the $rain. In proportional thinking as in creating something new making a decision and forming concepts my thinking relies on more direct access to the primary visual memory areas in my $rain. (here is a whole higher level of a$stract thinking seamlessly linked to emotion that I do not have.
Re;eren9e1 1. 6a,nedar ** ?uchs$aum *" *et,er * et at. !nterior cingulate gyrus volume and glucose meta$olism in autistic disorder. !merican >ournal of Psychiatry. 1887D 1:4D1F47-1F:F. 2. ?aron-%ohen " ing 6! Eheelwright ". "ocial intelligence in the normal and autistic $rainD an C*I study. &uropean >ournal of 0euroscience. 1888D 11D1981.1989. . "nyder !E *itchell >. Is integer arithmetic fundamental to mental processingH (he mind3s secret arithmetic. Proceedings of the oyal "ociety of +ondon. 1888D2AAD-:97-:82. 4. ?ir$aumer 0. ain *an3s revelations. 0ature. 1 888D88D211-212. :. *iller ?+ %ummings > *ishkin C. &mergence of artistic talent in froniotemporal dementia. 0eurology. 1889D:1D879-892. A. %layton >. +ost for Eords. 0ew "cientist. !pril 24 1888. pp.27-F. 7. &den 5C E amsey > et al. !$normal processing of artistic talent in dysleia revealed $y functional $rain imaging. 0ature. 188AD 92DAA-A8. 9. +eou >. (he &motional ?rain. "imon and "chusterG 188A. 8. (alling >% Earan 0@ Eathes %*. "ound avoidance $y domestic pigs depends on the characteristics of the signal. !pplied !nimal ?ehavior "cience. 1889D:9D 2::-2AA. 1F. ehaene " "pelke & Pinel P "tanescu (sivkin ". "ources of mathematical thinkingD ?ehavioral and $rain imaging evidence. "cience. 1888D 294D87F-87.
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T8in5in6 In Pi97:re1 C8ap7er , A:7i1m and #i1:al T8:687 Dr> Temple Grandin I (6I0@ I0 PI%(#&". Eords are like a second language to me. I translate $oth spoken and written words into full-color movies complete with sound which run like a <% tape in my head. Ehen some$ody speaks to me his words are instantly translated into pictures. +anguage-$ased thinkers often find this phenomenon difficult to understand $ut in my )o$ as an equipment designer for the livestock industry visual thinking is a tremendous advantage. urassic Park. Ehen I do an equipment simulation in my imagination or work on an engineering pro$lem it is like seeing it on a videotape in my mind. I can view it from any angle placing myself a$ove or $elow the equipment and rotating it at the same time. I don3t need a fancy graphics program that can produce three-dimensional design simulations. I can do it $etter and faster in my head.
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I create new images all the time $y taking many little parts of images I have in the video li$rary in my imagination and piecing them together. I have video memories of every item I3ve ever worked with -- steel gates fences latches concrete walls and so forth. (o create new designs I retrieve $its and pieces from my memory and com$ine them into a new whole. *y design a$ility keeps improving as I add more visual images to my li$rary. I add video-like images from either actual eperiences or translations of written information into pictures. I can visuali,e the operation of such things as squee,e chutes truck loading ramps and all different types of livestock equipment. (he more I actually work with cattle and operate equipment the stronger my visual memories $ecome. I first used my video li$rary in one of my early livestock design pro)ects creating a dip vat and cattle-handling facility for >ohn Eayne3s ed iver feed yard in !ri,ona. ! dip vat is a long narrow seven-foot-deep swimming pool through which cattle move in single file. It is filled with pesticide to rid the animals of ticks lice and other eternal parasites. In 1879 eisting dip vat designs were very poor. (he animals often panicked $ecause they were forced to slide into the vat down a steep slick concrete decline. (hey would refuse to )ump into the vat and sometimes they would flip over $ackward and drown. (he engineers who designed the slide never thought a$out why the cattle $ecame so frightened. (he first thing I did when I arrived at the feedlot was to put myself inside the cattle3s heads and look out through their eyes. ?ecause their eyes are on the sides of their heads cattle have wide-angle vision so it was like walking through the facility with a wide-angle video camera. I had spent the past si years studying how cattle see their world and watching thousands move through different facilities all over !ri,ona and it was immediately o$vious to me why they were scared. (hose cattle must have felt as if they were $eing forced to )ump down an airplane escape slide into the ocean. %attle are frightened $y high contrasts of light and dark as well as $y people and o$)ects that move suddenly. I3ve seen cattle that were handled in two identical facilities easily walk through one and $alk in the other. (he only difference $etween the two facilities was their orientation to the sun. (he cattle refused to move through the chute where the sun cast harsh shadows across it. #ntil I made this o$servation no$ody in the feedlot industry had $een a$le to eplain why one veterinary facility worked $etter than the other. It was a matter of o$serving the small details that made a $ig difference. (o me the dip vat pro$lem was even more o$vious. *y first step in designing a $etter system was collecting all the pu$lished information on eisting dip vats. ?efore doing anything else I always check out what is considered state-ofthe-art so I don3t waste time reinventing the wheel. (hen I turned to livestock pu$lications which usually have very limited information and my li$rary of video memories all of which contained $ad designs. Crom eperience with other types of equipment such as unloading ramps for trucks I had learned that cattle willingly walk down a ramp that has cleats to provide secure non slip footing. "liding causes them to panic and $ack up. (he challenge was to design an entrance that would encourage the cattle to walk in voluntarily and plunge into the water which was deep enough to su$merge them completely so that all the $ugs including those that collect in their ears would $e eliminated. I started running three-dimensional visual simulations in my imagination. I eperimented with different entrance designs and made the cattle walk through them in my imagination. (hree images merged to form the final designD a memory of a dip vat in =uma !ri,ona a porta$le vat I had seen in a maga,ine and an entrance ramp I had seen on a restraint device at the "wift meat-packing plant in (olleson !ri,ona. (he new dip vat entrance ramp was a modified version of the ramp I had seen there. *y design contained three features that had never $een used $eforeD an entrance that would not scare the animals an improved chemical filtration system and the use of animal $ehavior principles to prevent the cattle from $ecoming overecited when they left the vat. (he first thing I did was convert the ramp from steel to concrete. (he final design had a concrete ramp on a twenty five-degree downward angle. eep grooves in the concrete provided secure footing. (he ramp appeared to enter the water gradually $ut in reality it a$ruptly dropped away $elow the water3s surface. (he animals could not see the drop-off $ecause the dip chemicals colored the water. Ehen they stepped out over the water they quietly fell in $ecause their center of gravity had passed the point of no return.
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?efore the vat was $uilt I tested the entrance design many times in my imagination. *any of the cow$oys at the feedlot were skeptical and did not $elieve my design would work. !fter it was constructed they modified it $ehind my $ack $ecause they were sure it was wrong. ! metal sheet was installed over the non slip ramp converting it $ack to an old-fashioned slide entrance. (he first day they used it two cattle drowned $ecause they panicked and flipped over $ackward. Ehen I saw the metal sheet I made the cow$oys take it out. (hey were fla$$ergasted when they saw that the ramp now worked perfectly. &ach calf stepped out over the steep drop-off and quietly plopped into the water. I fondly refer to this design as /cattle walking on water./ ver the years I have o$served that many ranchers and cattle feeders think that the only way to induce animals to enter handling facilities is to force them in. (he owners and managers of feedlots sometimes have a hard time comprehending that if devices such as dip vats and restraint chutes are properly designed cattle will voluntarily enter them. I can imagine the sensations the animals would feel. If I had a calf3s $ody and hooves I would $e very scared to step on a slippery metal ramp. (here were still pro$lems I had to resolve after the animals left the dip vat. (he platform where they eit is usually divided into two pens so that cattle can dry on one side while the other side is $eing filled. 0o one understood why the animals coming out of the dip vat would sometimes $ecome ecited $ut I figured it was $ecause they wanted to follow their drier $uddies not unlike children divided from their classmates on a playground. I installed a solid fence $etween the two pens to prevent the animals on one side from seeing the animals on the other side. It was a very simple solution and it ama,ed me that no$ody had ever thought of it $efore. (he system I designed for filtering and cleaning the cattle hair and other gook out of the dip vat was $ased on a swimming pool filtration system. *y imagination scanned two specific swimming pool filters that I had operated one on my !unt ?recheen3s ranch in !ri,ona and one at our home. (o prevent water from splashing out of the dip vat I copied the concrete coping overhang used on swimming pools. (hat idea like many of my $est designs came to me very clearly )ust $efore I drifted off to sleep at night. ?eing autistic I don3t naturally assimilate information that most people take for granted. Instead I store information in my head as if it were on a %-* disc. Ehen I recall something I have learned I replay the video in my imagination. (he videos in my memory are always specificG for eample I remem$er handling cattle at the veterinary chute at Producer3s Ceedlot or *c&lhaney %attle %ompany. I remem$er eactly how the animals $ehaved in that specific situation and how the chutes and other equipment were $uilt. (he eact construction of steel fenceposts and pipe rails in each case is also part of my visual memory. I can run these images over and over and study them to solve design pro$lems. If I let my mind wander the video )umps in a kind of free association from fence construction to a particular welding shop where I3ve seen posts $eing cut and ld >ohn the welder making gates. If I continue thinking a$out ld >ohn welding a gate the video image changes to a series of short scenes of $uilding gates on several pro)ects I3ve worked on. &ach video memory triggers another in this associative fashion and my daydreams may wander far from the design pro$lem. (he net image may $e of having a good time listening to >ohn and the construction crew tell war stories such as the time the $ackhoe dug into a nest of rattlesnakes and the machine was a$andoned for two weeks $ecause every$ody was afraid to go near it. (his process of association is a good eample of how my mind can wander off the su$)ect. People with more severe autism have difficulty stopping endless associations. I am a$le to stop them and get my mind $ack on track. Ehen I find my mind wandering too far away from a design pro$lem I am trying to solve I )ust tell myself to get $ack to the pro$lem. Interviews with autistic adults who have good speech and are a$le to articulate their thought processes indicate that most of them also think in visual images. *ore severely impaired people who can speak $ut are una$le to eplain how they think have highly associational thought patterns. %harles 6art the author of /Eithout eason/ a $ook a$out his autistic son and $rother sums up his son3s thinking in one sentenceD /(ed3s thought processes aren3t logical they3re associational./ (his eplains3S (ed3s statement /I3m not afraid of planes. (hat3s why they fly so high./ In his mind planes fly high $ecause he is not afraid of themG he com$ines two pieces of information that planes fly high and that he is not afraid of heights.
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!nother indicator of visual thinking as the primary method of processing information is the remarka$le a$ility many autistic people ehi$it in solving )igsaw pu,,les finding their way around a city or memori,ing enormous amounts of information at a glance. *y own thought patterns are similar to those descri$ed $y !. . +uria in The Mind o" a Mnemonist . (his $ook descri$es a man who worked as a newspaper reporter and could perform ama,ing feats of memory. +ike me the mnemonist had a visual image for everything he had heard or read. +uria writes /Cor when he heard or read a word it was at once converted into a visual image corresponding with the o$)ect the word signified for him./ (he great inventor 0ikola (esla was also a visual thinker. Ehen he designed electric tur$ines for power generation he $uilt each tur$ine in his head. 6e operated it in his imagination and corrected faults. 6e said it did not matter whether the tur$ine was tested in his thoughts or in his shopG the results would $e the same. &arly in my career I got into fights with other engineers at meat-packing plants. I couldn3t imagine that they could $e so stupid as not to see the mistakes on the drawing $efore the equipment was installed. 0ow I reali,e it was not stupidity $ut a lack of visuali,ation skills. (hey literally could not see. I was fired from one company that manufactured meat-packing plant equipment $ecause I fought with the engineers over a design which eventually caused the collapse of an overhead track that moved 12FF-pound $eef carcasses from the end of a conveyor. !s each carcass came off the conveyor it dropped a$out three feet $efore it was a$ruptly halted $y a chain attached to a trolley on the overhead track. (he first time the machine was run the track was pulled out of the ceiling. (he employees fied it $y $olting it more securely and installing additional $rackets. (his only solved the pro$lem temporarily $ecause the force of the carcasses )erking the chains was so great. "trengthening the overhead track was treating a symptom of the pro$lem rather than its cause. I tried to warn them. It was like $ending a paper clip $ack and forth too many times. !fter a while it $reaks.
Di;;eren7 (a01 ; T8in5in6 (he idea that people have different thinking patterns is not new. Crancis 5alton in >n?uiries into .uman Faculty and (e)elopment wrote that while some people see vivid mental pictures for others /the idea is not felt to $e mental pictures $ut rather sym$ols of facts. In people with low pictorial imagery they would remem$er their $reakfast ta$le $ut they could not see it.33 It wasn3t until I went to college that I reali,ed some people are completely ver$al and think only in words. I first suspected this when I read an article in a science maga,ine a$out the development of tool use in prehistoric humans. "ome renowned scientist speculated that humans had to develop language $efore they could develop tools. I thought this was ridiculous and this article gave me the first inkling that my thought processes were truly different from those of many other people. Ehen I invent things I do not use language. "ome other people think in vividly detailed pictures $ut most think in a com$ination of words and vague generali,ed pictures. Cor eample many people see a generali,ed generic church rather than specific churches and steeples when they read or hear the word /steeple./ (heir thought patterns move from a general concept to specific eamples. I used to $ecome very frustrated when a ver$al thinker could not understand something I was trying to epress $ecause he or she couldn3t see the picture that was crystal clear to me. Curther my mind constantly revises general concepts as I add new information to my memory li$rary. It3s like getting a new version of software for the computer. *y mind readily accepts the new /software/ though I have o$served that some people often do not readily accept new information. #nlike those of most people my thoughts move from video like specific images to generali,ation and concepts. Cor eample my concept of dogs is inetrica$ly linked to every dog I3ve ever known. It3s as if I have a card catalog of dogs I have seen complete with pictures which continually grows as I add more eamples to my video li$rary. If I think a$out 5reat anes the first memory that pops into my head is ansk the 5reat ane owned $y the headmaster at my high school. (he net 5reat ane I visuali,e is 6elga who was ansk3s replacement. (he net is my aunt3s dog in !ri,ona and my final image comes from an advertisement for Citwell seat covers that featured that kind of dog. *y memories usually
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appear in my imagination in strict chronological order and the images I visuali,e are always specific. (here is no generic generali,ed 5reat ane. 6owever not all people with autism are highly visual thinkers nor do they all process information this way. People throughout the world are on a continuum of visuali,ation skills ranging from net to none to seeing vague generali,ed pictures to seeing semi-specific pictures to seeing as in my case in very specific pictures. I3m always forming new visual images when I invent new equipment or think of something novel and amusing. I can take images that I have seen rearrange them and create new pictures. Cor eample I can imagine what a dip vat would look like modeled on computer graphics $y placing it on my memory of a friend3s computer screen. "ince his computer is not programmed to do the fancy - rotary graphics I take computer graphics I have seen on (< or in the movies and superimpose them in my memory. In my visual imagination the dip vat will appear in the kind of high quality computer graphics shown on "tar (rek. I can then take a specific dip vat such as the one at ed iver and redraw it on the computer screen in my mind. I can even duplicate the cartoonlike three-dimensional skeletal image on the computer screen or imagine the dip vat as a videotape of the real thing. "imilarly I learned how to draw engineering designs $y closely o$serving a very talented draftsman when we worked together at the same feed yard construction company. avid was a$le to render the most fa$ulous drawings effortlessly. !fter I left the company I was forced to do all my own drafting. ?y studying avid3s drawings for many hours and photographing them in my memory I was actually a$le to emulate avid3s drawing style. I laid some of his drawings out so I could look at them while I drew my first design. (hen I drew my new plan and copied his style. !fter making three or four drawings I no longer had to have his drawings out on the ta$le. *y video memory was now fully programmed. %opying designs is one thing $ut after I drew the ed iver drawings I could not $elieve I had done them. !t the time I thought they were a gift from 5od. !nother factor that helped me to learn to draw well was something as simple as using the same tools that avid used. I used the same $rand of pencil and the ruler and straight edge forced me to slow down and trace the visual images in my imagination. *y artistic a$ilities $ecame evident when I was in first and second grade. I had a good eye for color and painted watercolors of the $each. ne time in fourth grade I modeled a lovely horse from clay. I )ust did it spontaneously though I was not a$le to duplicate it. In high school and college I never attempted engineering drawing $ut I learned the value of slowing down while drawing during a college art class. ur assignment had $een to spend two hours drawing a picture of one of our shoes. (he teacher insisted that the entire two hours $e spent drawing that one shoe. I was ama,ed at how well my drawing came out. Ehile my initial attempts at drafting were terri$le when I visuali,ed myself as avid the draftsman I3d automatically slow down.
Pr9e11in6 Nn
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putting dirt on my shoe. !ll of these memories play like videotapes in the <% in my imagination. If I allow my mind to keep associating it will wander a million miles away from the word /under/ to su$marines under the !ntarctic and the ?eatles song /=ellow "u$marine./ If I let my mind pause on the picture of the yellow su$marine I then hear the song. !s I start humming the song and get to the part a$out people coming on $oard my association switches to the gangway of a ship I saw in !ustralia. I also visuali,e ver$s. (he word /)umping/ triggers a memory of )umping hurdles at the mock lympics held at my elementary school. !dver$s often trigger inappropriate images -/quickly/ reminds me of 0estle3s Muik -- unless they are paired with a ver$ which modifies my visual image. Cor eample /he ran quickly/ triggers an animated image of ick from the firstgrade reading $ook running fast and /he walked slowly/ slows the image down. !s a child I left out words such as /is/ /the/ and /it/ $ecause they had no meaning $y themselves. "imilarly words like /of/ and /an/ made no sense. &ventually I learned how to use them properly $ecause my parents always spoke correct &nglish and I mimicked their speech patterns. (o this day certain ver$ con)ugations such as /to $e/ are a$solutely meaningless to me. Ehen I read I translate written words into color movies or I simply store a photo of the written page to $e read later. Ehen I retrieve the material I see a photocopy of the page in my imagination. I can then read it like a (eleprompter. It is likely that aymond the autistic savant depicted in the movie Rain Man used a similar strategy to memori,e telephone $ooks maps and other information. 6e simply photocopied each page of the phone $ook into his memory. Ehen he wanted to find a certain num$er he )ust scanned pages of the phone $ook that were in his mind. (o pull information out of my memory I have to replay the video. Pulling facts up quickly is sometimes difficult $ecause I have to play $its of different videos until I find the right tape. (his takes time. Ehen I am una$le to convert tet to pictures it is usually $ecause the tet has no concrete meaning. "ome philosophy $ooks and articles a$out the cattle futures market are simply incomprehensi$le. It is much easier for me to understand written tet that descri$es something that can $e easily translated into pictures. (he following sentence from a story in the Ce$ruary 21 1884 issue of Time maga,ine descri$ing the Einter lympics figure-skating championships is a good eampleD /!ll the elements are in place -- the spotlights the swelling walt,es and )a,, tunes the sequined sprites taking to the air./ In my imagination I see the skating rink and skaters. 6owever if I ponder too long on the word /elements/ I will make the inappropriate association of a periodic ta$le on the wall of my high school chemistry classroom. Pausing on the word /sprite/ triggers an image of a "prite can in my refrigerator instead of a pretty young skater. (eachers who work with autistic children need to understand associative thought patterns. !n autistic child will often use a word in an inappropriate manner. "ometimes these uses have a logical associative meaning and other times they don3t. Cor eample an autistic child might say the word /dog/ when he wants to go outside. (he word /dog/ is associated with going outside. In my own case I can remem$er $oth logical and illogical use of inappropriate words. Ehen I was si I learned to say /prosecution./ I had a$solutely no idea what it meant $ut it sounded nice when I said it so I used it as an eclamation every time my kite hit the ground. I must have $affled more than a few people who heard me eclaim /ProsecutionT/ to my downward-spiraling kite. iscussions with other autistic people reveal similar visual styles of thinking a$out tasks that most people do sequentially. !n autistic man who composes music told me that he makes /sound pictures/ using small pieces of other music to create new compositions. ! computer programmer with autism told me that he sees the general pattern of the program tree. !fter he visuali,es the skeleton for the program he simply writes the code for each $ranch. I use similar methods when I review scientific literature and trou$leshoot at meat plants. I take specific findings or o$servations and com$ine them to find new $asic principles and general concepts. *y thinking pattern always starts with specifics and works toward generali,ation in an associational and nonsequential way. !s if I were attempting to figure out what the picture on a )igsaw pu,,le is when only one third of the pu,,le is completed I am a$le to fill in the missing pieces $y scanning my video li$rary. %hinese mathematicians who can make large
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calculations in their heads work the same way. !t first they need an a$acus the %hinese calculator which consists of rows of $eads on wires in a frame. (hey make calculations $y moving the rows of $eads. Ehen a mathematician $ecomes really skilled he simply visuali,es the a$acus in his imagination and no longer needs a real one. (he $eads move on a visuali,ed video a$acus in his $rain.
A217ra97 T8:687 5rowing up I learned to convert a$stract ideas into pictures as a way to understand them. I visuali,ed concepts such as peace or honesty with sym$olic images. I thought of peace as a dove an Indian peace pipe or (< or newsreel footage of the signing of a peace agreement. 6onesty was represented $y an image of placing one3s hand on the ?i$le in court. ! news report descri$ing a person returning a wallet with all the money in it provided a picture of honest $ehavior. (he +ord3s Prayer was incomprehensi$le until I $roke it down into specific visual images. (he power and the glory were represented $y a semicircular rain$ow and an electrical tower. (hese childhood visual images are still triggered every time I hear the +ord3s Prayer. (he words /thy will $e done/ had no meaning when I was a child and today the meaning is still vague. Eill is a hard concept to visuali,e. Ehen I think a$out it I imagine 5od throwing a lightning $olt. !nother adult with autism wrote that he visuali,ed /(hou art in heaven/ as 5od with an easel a$ove the clouds. /(respassing/ was pictured as $lack and orange 0 (&"P!""I05 signs. (he word /!men/ at the end of the prayer was a mysteryD a man at the end made no sense. !s a teenager and young adult I had to use concrete sym$ols to understand a$stract concepts such as getting along with people and moving on to the net steps of my life $oth of which were always difficult. I knew I did not fit in with my high school peers and I was una$le to figure out what I was doing wrong. 0o matter how hard I tried they made fun of me. (hey called me /workhorse/ /tape recorder/ and /$ones/ $ecause I was skinny. !t the time I was a$le to figure out why theyS called me /workhorse/ and /$ones/ $ut /tape recorder/ pu,,led me. 0ow I reali,e that I must have sounded like a tape recorder when I repeated things ver$atim over and over. ?ut $ack then I )ust could not figure out why I was such a social dud. I sought refuge in doing things I was good at such as working on reroofing the $arn or practicing my riding prior to a horse show. Personal relationships made a$solutely no sense to me until I developed visual sym$ols of doors and windows. It was then that I started to understand concepts such as learning the give-and-take of a relationship. I still wonder what would have happened to me if I had not $een a$le to visuali,e my way in the world. (he really $ig challenge for me was making the transition from high school to college. People with autism have tremendous difficulty with change. In order to deal with a ma)or change such as leaving high school I needed a way to rehearse it acting out each phase in my life $y walking through an actual door window or gate. Ehen I was graduating from high school I would go and sit on the roof of my dormitory and look up at the stars and think a$out how I would cope with leaving. It was there I discovered a little door that led to a $igger roof while my dormitory was $eing remodeled. Ehile I was still living in this o1d 0ew &ngland house a much larger $uilding was $eing constructed over it. ne day the carpenters tore out a section of the o1d roof net to my room. Ehen I walked out I was now a$le to look up into the partially finished new $uilding. 6igh on one side was a small wooden door that led to the new roof. (he $uilding was changing and it was now time for me to change too. I could relate to that. I had found the sym$olic key. Ehen I was in college I found another door to sym$oli,e getting ready for graduation. It was a small metal trap door that went out onto the flat roof of the dormitory. I had to actually practice going through this door many times. Ehen I finally graduated from Cranklin Pierce I walked through a third very important door on the li$rary roof. I no longer use actual physical doors or gates to sym$oli,e each transition in my life. Ehen I reread years of diary entries while writing this $ook a clear pattern emerged. &ach door or gate ena$led me to move on to the net level. *y life was a series of incremental steps. I am often asked what the single $reakthrough was that ena$led me to adapt to autism. (here was no single $reakthrough. It was a series of incremental improvements. *y diary entries show
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very clearly that I was fully aware that when I mastered one door it was only one step in a whole series.
!pril 22 187F (oday everything is completed at Cranklin Pierce %ollege and it is now time to walk through the little door in the li$rary. I ponder now a$out what I should leave as a message on the li$rary roof for future people to find. I have reached the top of one step and I am now at the $ottom step of graduate school. Cor the top of the $uilding is the highest point on campus and I have gone as far as I can go now. I have conquered the summit of CP%. 6igher ones still remain unchallenged. - %lass 7F I went through the little door tonight and placed the plaque on the top of the li$rary roof. I was not as nervous this time. I had $een much more nervous in the past. 0ow I have already made it and the little door and the mountain had already $een clim$ed. (he conquering of this mountain is only the $eginning for the net mountain. (he word commencement means $eginning and the top of the li$rary is the $eginning of graduate school. It is human nature to strive and this is why people will clim$ mountains. (he reason why is that people strive to prove that they could do it. !fter all why should we send a man to the moonH (he only real )ustification is that it is human nature to keep striving out. *an is never satisfied with one goal he keeps reaching. (he real reason for going to the li$rary roof was to prove that I could do it. uring my life I have $een faced with five or si ma)or doors or gates to go through. I graduated from Cranklin Pierce a small li$eral arts college in 187F with a degree in psychology and moved to !ri,ona to get a Ph.. !s I found myself getting less interested in psychology and more interested in cattle and animal science I prepared myself for another $ig change in my life -- switching from a psychology ma)or to an animal science ma)or. n *ay 9 1871 I wroteD
I feel as if I am $eing pulled more and more in the farm direction. I walked through the cattle chute gate $ut I am still holding on tightly to the gate post. (he wind is $lowing harder and harder and I feel that I will let go of the gate post and go $ack to the farmG at least for a while. Eind has played an important part in many of the doors. n the roof the wind was $lowing. *ay$e this is a sym$ol that the net level that is reached is not ultimate and that I must keep moving on. !t the party Ua psychology department partyV I felt completely out of place and it seems as if the wind is causing my hands to slip from the gate post so that I can ride free on the wind. !t that time I still struggled in the social arena largely $ecause I didn3t have a concrete visual corollary for the a$straction known as /getting along with people./ !n image finally presented itself to me while I was washing the $ay window in the cafeteria students were required to do )o$s in the dining room;. I had no idea my )o$ would take on sym$olic significance when I started. (he $ay window consisted of three glass sliding doors enclosed $y storm windows. (o wash the inside of the $ay window I had to crawl through the sliding door. (he door )ammed while I was washing the inside panes and I was imprisoned $etween the two windows. In order to get out without shattering the door I had to ease it $ack very carefully. It struck me that relationships operate the same way. (hey also shatter easily and have to $e approached carefully. I then made a further association a$out how the careful opening of doors was related to esta$lishing relationships in the first place. Ehile I was trapped $etween the windows it
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was almost impossi$le to communicate through the glass. ?eing autistic is like $eing trapped like this. (he windows sym$oli,ed my feelings of disconnection from other people and helped me cope with the isolation. (hroughout my life door and window sym$ols have ena$led me to make progress and connections that are unheard of for some people with autism. In more severe cases of autism the sym$ols are harder to understand and often appear to $e totally unrelated to the things they represent. . Park and P. =ouderian descri$ed the use of visual sym$ols and num$ers $y >essy Park then a twelve-year-old autistic girl to descri$e a$stract concepts such as good and $ad. 5ood things such as rock music were represented $y drawings of four doors and no clouds. >essy rated most classical music as pretty good drawing two doors and two clouds. (he spoken word was rated as very $ad with a rating of ,ero doors and four clouds. "he had formed a visual rating system using doors and clouds to descri$e these a$stract qualities. >essy also had an ela$orate system of good and $ad num$ers though researchers have not $een a$le to decipher her system fully. *any people are totally $affled $y autistic sym$ols $ut to an autistic person they may provide the only tangi$le reality or understanding of the world. Cor eample /Crench toast/ may mean happy if the child was happy while eating it. Ehen the child visuali,es a piece of Crench toast he $ecomes happy. ! visual image or word $ecomes associated with an eperience. %lara Park >essy3s mother descri$ed her daughter3s fascination with o$)ects such as electric $lanket controls and heaters. "he had no idea why the o$)ects were so important to >essy though she did o$serve that >essy was happiest and her voice was no longer a monotone when she was thinking a$out her special things. >essy was a$le to talk $ut she was una$le to tell people why her special things were important. Perhaps she associated electric $lanket controls and heaters with warmth and security. (he word /cricket/ made her happy and /partly heard song/ meant /I don3t know./ (he autistic mind works via these visual associations. !t some point in >essy3s life a partly heard song was associated with not knowing. (ed 6art a man with severe autism has almost no a$ility to generali,e and no flei$ility in his $ehavior. 6is father %harles descri$ed how on one occasion (ed put wet clothes in the dresser after the dryer $roke. 6e )ust went on to the net step in a clothes-washing sequence that he had learned $y rote. 6e has no common sense. I would speculate that such rigid $ehavior and lack of a$ility to generali,e may $e partly due to having little or no a$ility to change or modify visual memories. &ven though my memories of things are stored as individual specific memories I am a$le to modify my mental images. Cor eample I can imagine a church painted in different colors or put the steeple of one church onto the roof of anotherG $ut when I hear some$ody say the word /steeple/ the first church that I see in my imagination is almost always a childhood memory and not a church image that I have manipulated. (his a$ility to modify images in my imagination helped me to learn how to generali,e. (oday I no longer need door sym$ols. ver the years I have $uilt up enough real eperiences and information from articles and $ooks I have read to $e a$le to make changes and take necessary steps as new situations present themselves. Plus I have always $een an avid reader and I am driven to take in more and more information to add to my video li$rary. ! severely autistic computer programmer once said that reading was /taking in information./ Cor me it is like programming a computer.
#i1:al T8in5in6 and Men7al Ima6er0 ecent studies of patients with $rain damage and of $rain imaging indicate that visual and ver$al thought may work via different $rain systems. ecordings of $lood flow in the $rain indicate that when a person visuali,es something such as walking through his neigh$orhood $lood flow increases dramatically in the visual corte in parts of the $rain that are working hard. "tudies of $rain-damaged patients show that in)ury to the left posterior hemisphere can stop the generation of visual images from stored long-term memories while language and ver$al memory are not impaired. (his indicates that visual imagery and ver$al thought may depend on distinct neurological systems. (he visual system may also contain separate su$systems for mental imagery and image rotation. Image rotation skills appear to $e located on the right side of the $rain whereas visual imagery is in the left rear of the $rain. In autism it is possi$le that the visual system
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has epanded to make up for ver$al and sequencing deficits. (he nervous system has a remarka$le a$ility to compensate when it is damaged. !nother part can take over for a damaged part. ecent research $y r. Pascual-+eone at the 0ational Institutes of 6ealth indicates that eercising a visual skill can make the $rain3s motor map epand. esearch with musicians indicates that real practice on the piano and imagining playing the piano have the same effect on motor maps as measured $y $rain scans. (he motor maps epand during $oth real piano playing and mental imageryG random pushing of the keys has no effect. !thletes have also found that $oth mental practice and real practice can improve a motor skill. esearch with patients with damage to the hippocampus has indicated that conscious memory of events and motor learning are separate neurological systems. ! patient with hippocampal damage can learn a motor task and get $etter with practice $ut each time he practices he will have no conscious memory of doing the task. (he motor circuits $ecome trained $ut damage to the hippocampus prevents the formation of new conscious memories. (herefore the motor circuits learn a new task such as solving a simple mechanical pu,,le $ut the person does not remem$er seeing or doing the pu,,le. Eith repeated practice the person gets $etter and $etter at it $ut each time the pu,,le is presented he says he has never seen it $efore. I am fortunate in that I am a$le to $uild on my li$rary of images and visuali,e solutions $ased on those pictures. 6owever most people with autism lead etremely limited lives in part $ecause they cannot handle any deviation from their routine. Cor me every eperience $uilds on the visual memories I carry from prior eperience and in this way my world continues to grow. !$out two years ago I made a personal $reakthrough when I was hired to remodel a meat plant that used very cruel restraint methods during kosher slaughter. Prior to slaughter live cattle were hung upside down $y a chain attached to one $ack leg. It was so horri$le I could not stand to watch it. (he frantic $ellows of terrified cattle could $e heard in $oth the office and the parking lot. "ometimes an animal3s $ack leg was $roken during hoisting. (his dreadful practice totally violated the humane intent of kosher slaughter. *y )o$ was to rip out this cruel system and replace it with a chute that would hold the animal in a standing position while the ra$$i performed kosher slaughter. one properly the animal should remain calm and would not $e frightened. (he new restraining chute was a narrow metal stall which held one steer. It was equipped with a yoke to hold the animal3s head a rear pusher gate to nudge the steer forward into the yoke and a $elly restraint which was raised under the $elly like an elevator. (o operate the restrainer the operator had to push si hydraulic control levers in the proper sequence to move the entrance and discharge gates as well as the head- and $ody-positioning devices. (he $asic design of this chute had $een around for a$out thirty years $ut I added pressureregulating devices and changed some critical dimensions to make it more comforta$le for the animal and to prevent ecessive pressure from $eing applied. Prior to actually operating the chute at the plant I ran it in the machine shop $efore it was shipped. &ven though no cattle were present I was a$le to program my visual and tactile memory with images of operating the chute. !fter running the empty chute for five minutes I had accurate mental pictures of how the gates and other parts of the apparatus moved. I also had tactile memories of how the levers on this particular chute felt when pushed. 6ydraulic valves are like musical instrumentsG different $rands of valves have a different feel )ust as different types of wind instruments do. perating the controls in the machine shop ena$led me to practice later via mental imagery. I had to visuali,e the actual controls on the chute and in my imagination watch my hands pushing the levers. I could feel in my mind how much force was needed to move the gates at different speeds. I rehearsed the procedure many times in my mind with different types of cattle entering the chute. n the first day of operation at the plant I was a$le to walk up to the chute and run it almost perfectly. It worked $est when I operated the hydraulic levers unconsciously like using my legs for walking. If I thought a$out the levers I got all mied up and pushed them the wrong way. I had to force myself to rela and )ust allow the restrainer to $ecome part of my $ody while completely forgetting a$out the levers. !s each animal entered I concentrated on moving the apparatus slowly and gently so as not to scare him. I watched his reactions so that I applied only enough pressure to hold him snugly. &cessive pressure would cause discomfort.
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If his ears were laid $ack against his head or he struggled I knew I had squee,ed him too hard. !nimals are very sensitive to hydraulic equipment. (hey feel the smallest movement of the control levers. (hrough the machine I reached out and held the animal. Ehen I held his head in the yoke I imagined placing my hands on his forehead and under his chin and gently easing him into position. ?ody $oundaries seemed to disappear and I had no awareness of pushing the levers. (he rear pusher gate and head yoke $ecame an etension of my hands. People with autism sometimes have $ody $oundary pro$lems. (hey are una$le to )udge $y feel where their $ody ends and the chair they are sitting on or the o$)ect they are holding $egins much like what happens when a person loses a lim$ $ut still eperiences the feeling of the lim$ $eing there. In this case the parts of the apparatus that held the animal felt as if they were a continuation of my own $ody similar to the phantom lim$ effect. If I )ust concentrated on holding the animal gently and keeping him calm I was a$le to run the restraining chute very skillfully. uring this intense period of concentration I no longer heard noise from the plant machinery. I didn3t feel the sweltering !la$ama summer heat and everything seemed quiet and serene. It was almost a religious eperience. It was my )o$ to hold the animal gently and it was the ra$$i3s )o$ to perform the final deed. I was a$le to look at each animal to hold him gently and make him as comforta$le as possi$le during the last moments of his life. I had participated in the ancient slaughter ritual the way it was supposed to $e. ! new door had $een opened. It felt like walking on water.
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Tea98in6 Tip1 ;r C8ildren and Ad:l71 4i78 A:7i1m Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e Uni
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child. (o reduce frustration and help the child to en)oy writing let him type on the computer. (yping is often much easier. 7.; "ome autistic children will learn reading more easily with phonics and others will learn $est $y memori,ing whole words. I learned with phonics. *y mother taught me the phonics rules and then had me sound out my words. %hildren with lots of echolalia will often learn $est if flash cards and picture $ooks are used so that the whole words are associated with pictures. It is important to have the picture and the printed word on the same side of the card. Ehen teaching nouns the child must hear you speak the word and view the picture and printed word simultaneously. !n eample of teaching a ver$ would $e to hold a card that says /)ump/ and you would )ump up and down while saying /)ump./ 9.; Ehen I was a child loud sounds like the school $ell hurt my ears like a dentist drill hitting a nerve. %hildren with autism need to $e protected from sounds that hurt their ears. (he sounds that will cause the most pro$lems are school $ells P! systems $u,,ers on the score $oard in the gym and the sound of chairs scraping on the floor. In many cases the child will $e a$le to tolerate the $ell or $u,,er if it is muffled slightly $y stuffing it with tissues or duct tape. "craping chairs can $e silenced $y placing slit tennis $alls on the ends of the legs or installing carpet. ! child may fear a certain room $ecause he is afraid he may $e suddenly su$)ected to squealing microphone feed$ack from the P! system. (he fear of a dreaded sound can cause $ad $ehavior. If a child covers his ears it is an indicator that a certain sound hurts his ears. "ometimes sound sensitivity to a particular sound such as the fire alarm can $e desensiti,ed $y recording the sound on a tape recorder. (his will allow the child to initiate the sound and gradually increase its volume. (he child must have control of play$ack of the sound. 8.; "ome autistic people are $othered $y visual distractions and fluorescent lights. (hey can see the flicker of the AF-cycle electricity. (o avoid this pro$lem place the child3s desk near the window or try to avoid using fluorescent lights. If the lights cannot $e avoided use the newest $ul$s you can get. 0ew $ul$s flicker less. (he flickering of fluorescent lights can also $e reduced $y putting a lamp with an old-fashioned incandescent light $ul$ net to the child3s desk. 1F.; "ome hyperactive autistic children who fidget all the time will often $e calmer if they are given a padded weighted vest to wear. Pressure from the garment helps to calm the nervous system. I was greatly calmed $y pressure. Cor $est results the vest should $e worn for twenty minutes and then taken off for a few minutes. (his prevents the nervous system from adapting to it. 11.; "ome individuals with autism will respond $etter and have improved eye contact and speech if the teacher interacts with them while they are swinging on a swing or rolled up in a mat. "ensory input from swinging or pressure from the mat sometimes helps to improve speech. "winging should always $e done as a fun game. It must 0&<& $e forced. 12.; "ome children and adults can sing $etter than they can speak. (hey may respond $etter if words and sentences are sung to them. "ome children with etreme sound sensitivity will respond $etter if the teacher talks to them in a low whisper. 1.; "ome nonver$al children and adults cannot process visual and auditory input at the same time. (hey are mono-channel. (hey cannot see and hear at the same time. (hey should not $e asked to look and listen at the same time. (hey should $e given either a visual task or an auditory task. (heir immature nervous system is not a$le to process simultaneous visual and auditory input. 14.; In older nonver$al children and adults touch is often their most relia$le sense. It is often easier for them to feel. +etters can $e taught $y letting them feel plastic letters. (hey can learn their daily schedule $y feeling o$)ects a few minutes $efore a scheduled activity. Cor eample fifteen minutes $efore lunch give the person a spoon to hold. +et them hold a toy car a few minutes $efore going in the car. 1:.; "ome children and adults with autism will learn more easily if the computer key-$oard is placed close to the screen. (his ena$les the individual to simultaneously see the key$oard and screen. "ome individuals have difficulty remem$ering if they have to look up after they have hit a key on the key$oard. 1A.; 0onver$al children and adults will find it easier to associate words with pictures if they see the printed word and a picture on a flashcard. "ome individuals do not under-stand line
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drawings so it is recommended to work with real o$)ects and photos first. (he picture and the word must $e on the same side of the card. 17.; "ome autistic individuals do not know that speech is used for communication. +anguage learning can $e facilitated if language eercises promote communication. If the child asks for a cup then give him a cup. If the child asks for a plate when he wants a cup give him a plate. (he individual needs to learn that when he says words concrete things happen. It is easier for an individual with autism to learn that their words are wrong if the incorrect word resulted in the incorrect o$)ect. 19.; *any individuals with autism have difficulty using a computer mouse. (ry a roller $all or tracking $all; pointing device that has a separate $utton for clicking. !utistics with motor control pro$lems in their hands find it very difficult to hold the mouse still during clicking. 18.; %hildren who have difficulty understanding speech have a hard time differentiating $etween hard consonant sounds such as 33 in dog and 3+3 in log. *y speech teacher helped me to learn to hear these sounds $y stretching out and enunciating hard consonant sounds. &ven though the child may have passed a pure tone hearing test he may still have difficulty hearing hard consonants. %hildren who talk in vowel sounds are not hearing consonants. 2F.; "everal parents have informed me that using the closed captions on the television helped their child to learn to read. (he child was a$le to read the captions and match the printed works with spoken speech. ecording a favorite program with captions on a tape would $e helpful $ecause the tape can $e played over and over again and stopped. 21.; "ome autistic individuals do not understand that a computer mouse moves the arrow on the screen. (hey may learn more easily if a paper arrow that looks &L!%(+= like the arrow on the screen is taped to the mouse. 22.; %hildren and adults with visual processing pro$lems can see flicker on (< type computer monitors. (hey can sometimes see $etter on laptops and flat panel displays which have less flicker. 2.; %hildren and adults who fear escalators often have visual processing pro$lems. (hey fear the escalator $ecause they cannot determine when to get on or off. (hese individuals may also not $e a$le to tolerate fluorescent lights. (he Irlen colored glasses may $e helpful for them. 24.; Individuals with visual processing pro$lems often find it easier to read if $lack print is printed on colored paper to reduce contrast. (ry light tan light $lue gray or light green paper. &periment with different colors. !void $right yellow--it may hurt the individual3s eyes. Irlen colored glasses may also make reading easier. %lick here to visit the Irlen Institute3s we$ site.; 2:.; (eaching generali,ation is often a pro$lem for children with autism. (o teach a child to generali,e the principle of not running across the street it must $e taught in many different locations. If he is taught in only one location the child will think that the rule only applies to one specific place. 2A.; ! common pro$lem is that a child may $e a$le to use the toilet correctly at home $ut refuses to use it at school. (his may $e due to a failure to recogni,e the toilet. 6ilde de %lereq from ?elgium discovered that an autistic child may use a small non-relevant detail to recogni,e an o$)ect such as a toilet. It takes detective work to find that detail. In one case a $oy would only use the toilet at home that had a $lack seat. 6is parents and teacher wer e a$le to get him to use the toilet at school $y covering its white seat with $lack tape. (he tape was then gradually removed and toilets with white seats were now recogni,ed as toilets. 27.; "equencing is very difficult for individuals with severe autism. "ometimes they do not understand when a task is presented as a series of steps. !n occupational therapist successfully taught a nonver$al autistic child to use a playground slide $y walking his $ody through clim$ing the ladder and going down the slide. It must $e taught $y touch and motor rather than showing him visually. Putting on shoes can $e taught in a similar manner. (he teacher should put her hands on top of the childs hands and move the childs hands over his foot so he feels and understands the shape of his foot. (he net step is feeling the inside and the outside of a slip-on shoe. (o put the shoe on the teacher guides the childs hands to the shoe and using the hand-over-hand method slides the shoe onto the childs foot. (his ena$les the child to feel the entire task of putting on his shoe. 29.; Cussy eating is a common pro$lem. In some cases the child may $e fiated on a detail that identifies a certain food. 6ilde de %lerq found that one child only ate %hiquita $ananas
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$ecause he fiated on the la$els. ther fruit such as apples and oranges were readily accepted when %hiquita la$els were put on them. (ry putting different $ut similar foods in the cereal $o or another package of a favorite food. !nother mother had success $y putting a homemade ham$urger with a wheat free $un in a *conalds package.
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Fre:en7l0 A15ed $:e17in1 a2:7 A:7i1m Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e Uni H4 d I 5n4 i; m0 98ild 8a1 pr2lem1 4i78 1en1r0
"ounds or visual stimuli that are tolerated $y normal children may cause pain confusion and'or fear in some autistic children. "ensory over sensitivity can vary from very slight to severe. If your child frequently puts his hands over his ears this is an indicator of sensitivity to noise. %hildren who flick their fingers in front of their eyes are likely to have visual sensitivity pro$lems. %hildren who en)oy a trip to a large super-market or a shopping mall usually have relatively mild sensory sensitivities. !utistic children with severe sensory sensitivities will often have tantrums and other $ad $ehavior in a shopping mall due to sensory overload. (hese children are the ones who will most likely need environmental modifications in the classroom. lder children and adults who remain nonver$al and have very little language often have more severe sensitivities than individuals with good language. %hildren with auditory or visual sensitivity will often have normal hearing and visual acuity tests. (he pro$lem is in the $rain whereas the ears and eyes are normal. > (8a7 1i6871 and 1:nd1 are m17 li5el0 7 9a:1e 1en1r0
&very autistic child or adult is different. ! sound or sight which is painful to one autistic child may $e attractive to another. (he flicker of fluorescent lighting can $e seen $y some children with autism and may $e distracting to them. It is mostly likely to cause sensory overload in children who flick their fingers in front of their eyes. eplacing fluorescents with incandescent $ul$s will $e helpful for some children. *any children with autism are scared of the pu$lic address system the school $ells or the fire alarms $ecause the sound hurts their ears. "creeching electronic feed$ack from pu$lic address systems or the sound of fire alarms are the worst sounds $ecause the onset of the sound can0( $e predicted. %hildren with milder hearing sensitivity can sometimes learn to tolerate hurtful sounds when they know when they will occur. 6owever they may 0&<& learn to tolerate #0epected loud noise. !utistic children with severe hearing sensitivity should $e removed from the classroom prior to a fire drill. (he fear of a hurtful sound may make an autistic child fearful of a certain classroom. 6e may $ecome afraid to go into the room $ecause he fears that the fire alarm or the pu$lic address systems may make a hurtful sound. If possi$le the $u,,es or $ell should $e modified to reduce the sound. "ometimes only a slight reduction in sound is required to make a $u,,er or $ell tolera$le. uct tape can $e applied to $ells to soften the sounds. If the pu$lic address system has frequent feed$ack pro$lems it should $e disconnected. &choes and noise can $e reduced $y installing carpeting -- carpet remnants can sometimes $e o$tained from a carpet store at a low cost. "craping of chair legs on the floor can $e muffled $y placing cut tennis $alls on the chair legs. 3> (80 de1 m0 98ild a<id 9er7ain ;d1 r al4a01 4an7 7 ea7 78e 1ame 78in6.
%ertain foods may $e avoided due to sensory over sensitivity. %runchy foods such as potato chips may $e too loud and sound like a raging forest fire to children with over sensitive hearing. %ertain odors may $e overpowering. Ehen I was a child I gagged when I had to eat slimy foods like )ello. 6owever some limited food preferences may $e $ad ha$its and are not due to sensory pro$lems. ne has to $e a careful o$server to figure out which foods cause sensory pain. Cor eample if a child has etreme sound sensitivity he should not $e required to eat loud crunchy foodsG $ut he should $e encouraged to eat a variety of softer foods. Ehen I was a child my parents made me eat everything ecept the two things which really made me gag. (hey were under-cooked slimy egg whites and )ello. I was allowed to have a grilled
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cheese sandwich everyday for lunch $ut at dinnertime I was epected to eat everything that was not slimy. (o motivate a child to eat something he does not like it is recommended to have a food he really likes such as pi,,a right in front of him along with the food he dislikes. 6e is then told that he can have the pi,,a after he eats a few $ites of peas. It is important to have the pi,,a right there in front of him to motivate eating something he does not like. > H4 d I 7ile7 7rain m0 a:7i17i9 98ild.
(here are two ma)or causes of toilet training pro$lems in children with autism. (hey are either afraid of the toilet or they do not know what they are supposed to do. %hildren with severe hearing sensitivity may $e terrified of the toilet flushing. (he sound may hurt their ears. "ometimes these children can learn if they use a potty chair which is located away from the frightening toilet. ue to the great varia$ility of sensory pro$lems some children may like to repeatedly flush the toilet $ut they are still not trained. (he thinking of some autistic children is so concrete that the only way they can learn is to have an adult demonstrate to them how to use the toilet. (hey have to see someone else do it in order to learn. "ome children with very severe sensory processing pro$lems are not a$le to accurately sense when they need to use the $athroom. If they are calm they may $e a$le to feel the sensation that they need to urinate or defecate $ut if they eperience sensory overload they cannot feel it. (his may eplain why a child will sometimes use the toilet correctly and other times he will not. "> (80 d 1me a:7i17i9 98ildren repea7 2a95 48a7 an ad:l7 8a1 1aid r 1in6 T# 9mmer9ial1.
epeating $ack what has $een said or $eing a$le to sing an entire (< commercial or children3s video is called 3echolalia.3 &cholalia is actually a good sign $ecause it indicates that the child3s $rain is processing language even though he may not $e understanding the meaning of the words. (hese children need to learn that words are used for communication. If a child says the word 3apple3 immediately give him an apple. (his will ena$le the child to associate the word 3apple3 with getting a real apple. "ome autistic children use phrases from (< commercials or children3s videos in an appropriate manner in other situations. (his is how they learn language. Cor eample if a child says part of a $reakfast cereal slogan at $reakfast give him the cereal. !utistic children also use echolalia to verify what has $een said. "ome children have difficulty hearing hard consonant sounds such as /d/ in dog or /$/ in $oy. epeating the phrase helps them to hear it. %hildren who pass a pure tone hearing test can still have difficulty hearing comple speech sounds. %hildren with this difficulty may learn to read and speak $y using flash cards that have $oth a printed word and a picture of an o$)ect. ?y using these cards they learn to associate the spoken word with the printed word and a picture. *y speech therapist helped me to learn to hear speech $y lengthening hard consonant sounds. "he would hold up a $all and say /$$$$ all./ (he hard consonant sound of /$/ was lengthened. "ome autistic children learn vowel sounds more easily than consonants. '> H4 18:ld ed:9a7r1 and paren71 8andle a:7i17i9 ;i?a7in1 n 78in61 1:98 a1 la4n m4er1 r 7rain1.
Ciations should $e used to motivate schoolwork and education. If a child is fiated on trains use his interest in trains to motivate reading or learning arithmetic. 6ave him read a$out trains or do arithmetic pro$lems with trains. (he intense interest in trains can $e used to motivate reading. It is a mistake to take fiations away $ut the child needs to learn that there are some situations when talking a$out trains is not appropr iate. (he idea is to $roaden the fiation into a less fiated educational or social activity. If a child likes to spin a penny then start playing a game with the child where you and the child take turns playing with the penny. (his also helps to teach turn taking. ! train fiation could $e $roadened in studying history. ! high-functioning child would $e motivated to read a $ook a$out the history of the railroad. ne should $uild and $roaden fiation into useful activities. *y career in livestock equipment design started as a fiation on cattle chutes. *y high school science teacher encouraged me to study science to learn more a$out my fiation. 6igh functioning autistic and !sperger teenagers need mentors to help them develop their talents into a career skill. (hey need some$ody to teach them computer programming or
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graphic arts. ! local computer professional could serve as a mentor or the individual may $e a$le to take a programming class at a community college. *any parents wonder where they can find a mentor for their teenager. (ry posting a notice on a $ulletin $oard at a university computer science department or strike up a conversation with the man in the supermarket checkout line who is wearing a $adge with the name of a computer company on it. I found one of my mentors in the $usiness world when I met the wife of his insurance agent. )> (8a7 i1 78e di;;eren9e 2e74een PDD and a:7i1m.
!utism and P are $ehavioral diagnoses. !t the present time there are no medical tests for autism. !utism is diagnosed $ased on the child3s $ehavior. ?oth children diagnosed with autism and P will $enefit from education programs designed for autistics. It is essential that children diagnosed as P receive the same education as children diagnosed with autism. ?oth autistic and P children should $e placed into a good early education program immediately after diagnosis. %hildren diagnosed with P tend to fall into two groupsD 1; very mild autistic symptoms or 2; some autistic symptoms in a child who has other severe neurological pro$lems. (herefore some children diagnosed as P may $e almost normalG and others have severe neurological pro$lems such as epilepsy microencephaly or cere$ral palsy. (he pro$lem with the autism and P diagnoses is that they are 0( precise. (hey are $ased only on $ehavior. In the future $rain scans will $e used for precise diagnosis. (oday there is no $rain scan that can $e used for diagnosing P nor autism. *> (80 i1 Earl0 In7er
?oth scientific studies and practical eperience have shown that the prognosis is greatly improved if a child is placed into an intense highly structured educational program $y age two or three. !utistic children perform stereotypic $ehaviors such as rocking or twiddling a penny $ecause engaging in repetitive $ehaviors shuts off sounds and sights which cause confusion and'or pain. (he pro$lems is that if the child is allowed to shut out the world his $rain will not develop. !utistic and P children need many hours of structured education to keep their $rain engaged with the world. (hey need to $e kept interacting in a meaningful way with an adult or another child. (he worst things for a young two to five year old autistic child is to sit alone watching (< or playing video games all day. 6is $rain will $e shut off from the world. !utistic children need to $e kept engagedG $ut at the same time a teacher must $e careful to avoid sensory overload. %hildren with milder sensory pro$lems often respond well to +ovaastype programs. 6owever children with more severe sensory processing pro$lems may eperience sensory overload. (here are two ma)or categories of children. (he first type will respond well to a therapist who is gently intrusive and pulls them out of their world. I was this type. *y speech therapist was a$le to /snap me out of it/ $y gra$$ing my chin and making me pay attention. (he second type of child has more neurological pro$lems and they may respond poorly to a strict +ovaas program. (hey will require a gentler approach. "ome are 3monochannel3 $ecause they cannot see and hear at the same time. (hey either have to look at something or they have to listen. "imultaneous looking and listening may result in sensory overload and shutdown. (his type of child may respond $est when the teacher whispers quietly in a dimly illuminated room. ! good teacher needs to tailor his'her teaching method to the child. (o $e successful the teacher has to $e gently insistent. ! good teacher knows how hard to push. (o $e successful the teacher has to intrude into the autistic child3s world. Eith some children the teacher can )erk open their /front doorG/ and with other children the teacher has to sneak quietly in their /$ack door./ +> (80 de1 m0 98ild 4an7 7 4ear 78e 1ame 9l78e1 all 78e 7ime.
"tiff scratching clothes or wool against my skin is sandpaper ripping off raw nerve endings. I am not a$le to tolerate scratching clothes. !utistic children will $e most comforta$le with soft cotton against their skin. 0ew underwear and shirts will $e more comforta$le if they are washed several times. It is often $est to avoid spray starch or fa$ric softeners that are placed in the dryer. "ome children are allergic to them. U0oteD %aretakers and teachers should also avoid the use of perfume $ecause some children hate the smell and'or they are allergic to it.V
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&ven today at the age of 48 I have had to find good clothes and work clothes that feel the same. It takes me up to two weeks to ha$ituate to the feeling of wearing a skirt. If I wear shorts during the summer it takes at least a week $efore long pants $ecome fully tolera$le. (he pro$lem is switching $ack-and-forth. "witching $ack-and-forth can $e made more tolera$le $y wearing tights with skirts. (he tights make the skirt feel the same as long pants.
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C81in6 78e Ri687 2 ;r Peple 4i78 A:7i1m r A1per6er1 S0ndrme Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e Unio$s need to $e chosen that make use of the strengths of people with autism or !sperger3s syndrome. ?oth high and low functioning people have very poor short-term working memory $ut they often have a $etter long-term memory than most normal people. I have great difficulty with tasks that put high demands on short-term working memory. I cannot handle multiple tasks at the same time. (a$le 1 is a list of ?! )o$s that I would have great difficulty doing. (a$le 2 is a list of easy )o$s for a visual thinker like me. I have difficulty doing a$stract math such as alge$ra and most of the )o$s on (a$le 2 do not require comple math. *any of the visual thinking )o$s would also $e good for people with dysleia. (he visual thinking )o$s on (a$le 2 put very little demand on fast processing of information in short-term working memory. (hey would fully utili,e my visual thinking and large long-term memory. (a$le is a list of )o$s that non-visual thinkers who are good with num$ers facts and music could do easily. (hey also put low demands on short-term working memory and utili,e an ecellent long-term memory. (a$le 4 shows )o$s that lower functioning people with autism could do well. Cor all types of autism and !sperger3s syndrome demands on short-term working memory must $e kept low. If I were a computer I would have a huge hard drive that could hold 1F times as much information as an ordinary computer $ut my processor chip would $e small. (o use 1888 computer terminology I have a 1FFF giga$yte hard drive and a little 29A processor. 0ormal people may have only 1F giga$ytes of disc space on their hard drive and a Pentium for a processor. I cannot do two or three things at once. "ome )o$ tips for people with autism or !sperger3s syndromeD >o$s should have a well-defined goal or endpoint. "ell your work not your personality. *ake a portfolio of your work. (he $oss must recogni,e your social limitations. It is important that high functioning autistics and !sperger3s syndrome people pick a college ma)or in an area where they can get )o$s. %omputer science is a good choice $ecause it is very likely that many of the $est programmers have either !sperger3s syndrome or some of its traits. ther good ma)ors areD accounting engineering li$rary science and art with an emphasis on commercial art and drafting. *a)ors in history political science $usiness &nglish or pure math should $e avoided. 6owever one could ma)or in li$rary science with a minor in history $ut the li$rary science degree makes it easier to get a good )o$. "ome individuals while they are still in high school should $e encouraged to take courses at a local college in drafting computer programming or commercial art. (his will help keep them motivated and serve as a refuge from teasing. Camilies with low income may $e wondering how they can afford computers for their child to learn programming or computer aided drafting. #sed computers can often $e o$tained for free or at a very low cost when a $usiness or an engineering company upgrades their equipment. *any people do not reali,e that there are many usa$le older computers sitting in storerooms at schools $anks factories and other $usinesses. It will not $e the latest new thing $ut it is more than adequate for a student to learn on. In conclusionD a person with !sperger3s syndrome or autism has to compensate for poor social skills $y making themselves so good in a speciali,ed field that people will $e willing to /$uy/ their skill even though social skills are poor. (his is why making a portfolio of your work is so important. =ou need to learn a few social survival skills $ut you will make friends at work $y • • •
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sharing your shared interest with the other people who work in your specialty. *y social life is almost all work related. I am friends with people I do interesting work with.
Ta2le , ?ad >o$s for People with 6igh Cunctioning !utism or !sperger3s "yndromeD >o$s that require high demands on short-term working memory !ashier -- making change quickly puts too much demand on short-term working memory Short order coo= -- 6ave to keep track of many orders and cook many different things at the same time
•
• • • • • • • •
Ta2le •
•
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•
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• •
• • •
•
•
5ood >o$s for o$s are scarce and the field is overcrowded. (here are many more )o$s in industrial communications $usiness and software design computer programming. !nother $ad thing a$out this )o$ is eposure to violent images. !omputer animation --
Temple Grandin
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?usinesses are recruiting immigrants from overseas $ecause there is a shortage of good programmers in $usiness and industrial fields. +uilding maintenance -- Cies $roken pipes windows and other things in an apartment comple hotel or office $uilding Factory maintenance -- epairs and fies factory equipment
Ta2le 3 • •
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• •
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•
5ood >o$s for 0on-n)entory control -- @eeps track of merchandise stocked in a store Tuning pianos and other musical instruments, can $e done as freelance work Laboratory technician -- unning la$oratory equipment +an= Teller -- o$s are much more plentiful in computer programming and accounting.
Ta2le >o$s for 0onver$al People with !utism or People with Poor
Reshel)ing library boo=s -- %an memori,e the entire num$ering system and shelf
locations • • • • • • • • •
Factory assembly /or= -- &specially if the environment is quiet !opy shop -- unning photocopies. Printing )o$s should $e lined up $y some$ody else 'anitor obs -- %leaning floors toilets windows and offices Restoc=ing shel)es -- In many types of stores Recycling plant -- "orting )o$s
memory •
#lant care -- Eater plants in a large office $uilding
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ED> A11i17an7 Pr;e11r Clrad S7a7e Uni
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he went $erserk. (his is due to a slow $uildup in the system. (his is especially a pro$lem with Pro,ac. (he dose must $e lowered at the first indication of insomnia. In this article I have not discussed the full range of medications that can $e used for autism. (he $asic principles of assessing risk versus $enefit and using a $lind evaluation should $e used with all types of medications which are used to improve a child3s $ehavior and'or language development.
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S9ial Pr2lem1 Under17andin6 Em7in1 and DeD> A11i17an7 Pr;e11r Clrad S7a7e Uniohn sees "ally put a candy in a )ar and then "ally eats the candy when >ohn leaves the room and replaces it with a pen I know that >ohn epects to find a candy $ecause he did not see the candy replaced $y the pen. I have difficulty with more comple 3theory of mind3 pro$lems which involve two or three people doing several different things. I do not have sufficient short-term memory to remem$er the sequence of events. *y pro$lem is due to a poor short-term working memory. ifficulties with short-term working memory should not $e confused with a lack of understanding of 3theory of mind.3 I can solve more comple 3theory of mind3 tests if I am allowed to write down the sequence of events. ver time I have $uilt up a tremendous li$rary of memories of my past eperiences (< movies and newspapers to spare me the social em$arrassments caused $y my autismG and I use these to guide the decision process in a totally logical way. I have learned from eperience that certain $ehaviors make people mad. &arlier in my life my logical decisions were often wrong $ecause they were $ased on insufficient data. (oday they are much $etter $ecause my memory contains more information. #sing my visuali,ation a$ility I o$serve myself from a distance. I call this my little scientist in the corner as if I3m a little $ird watching my own $ehavior from up high. (his idea has also $een reported $y other people with autism. r. !sperger noted that autistic children o$serve themselves constantly. (hey see themselves as an o$)ect of interest. !ccording to !ntonio amasio people who suddenly lose emotions $ecause of strokes often make disastrous financial and social decisions. (hese patients have completely normal thoughts and they respond normally when asked a$out hypothetical social situations. ?ut their performance plummets when they have to make rapid decisions without emotional cues. It must $e like suddenly $ecoming autistic. I can handle situations where stroke patients may fail $ecause I never relied on emotional cues in the first place. !t age :1 I have a vast data $ankG $ut it has taken me years to $uild up my li$rary of eperiences and learn how to $ehave in an
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appropriate manner. I did not know until very recently that most people rely heavily on emotional cues. !fter many years I have learned - $y rote - how to act in different situations. I can speedsearch my %-* memory of videotapes and make a decision quickly. It is like surfing the Internet in my mind. oing this visually may $e easier than doing it with ver$al thinking. I try to avoid situations where I can get into trou$le. !s a child I found picking up social cues impossi$le. Ehen my parents were thinking a$out getting divorced my sister felt tensionG $ut I felt nothing $ecause the signs were su$tle. *y parents never had $ig fights in front of us. (he signs of emotional friction were stressful to my sister $ut I didn3t even see them. "ince my parents were not showing o$vious overt anger toward each otherG I )ust did not comprehend the tension. "ocial interaction is further complicated $y the physiological pro$lems of attention shifting. "ince people with autism require much more time than others to shift their attention $etween auditory and visual stimuli they find it more difficult to follow rapidly changing comple social interactions. (hese pro$lems may $e part of the reason why >ack a man with autism said /If I relate to people too much I $ecome nervous and uncomforta$le./ +earning social skills can $e greatly helped with videotapes. I gradually learned to improve my pu$lic speaking $y watching tapes and $y $ecoming aware of easily quantifia$le cues such as rustling papers that indicate $oredom. It is a slow process of continuous improvement. (here are no sudden $reakthroughs. Ciguring out how to interact socially was much more difficult than solving an engineering pro$lem. I found it relatively easy to program my visual memory with the knowledge of cattledipping vats or corral designs. ecently I attended a lecture where a social scientist said that humans do not think like computers. (hat night at a dinner party I told this scientist and her friends that my thought patterns resem$le computing and that I am a$le to eplain my thought processes step $y step. I was kind of shocked when she told me that she is una$le to descri$e how her thoughts and emotions are )oined. "he said that when she thinks a$out something the factual information and the emotions are com$ined into a seamless whole. I finally understood why so many people allow emotions to distort the facts. *y mind can always separate the two. &ven when I am very upset I keep reviewing the facts over and over until I can come to a logical conclusion. ver the years I have learned to $e more tactful and diplomatic. In my freelance livestock equipment design $usiness I have learned never to go over the head of the person who hired me unless I have his or her permission. Crom past eperiences I have learned to avoid situations in which I could $e eploited and to stroke egos that may feel threatened. (o master diplomacy I read a$out $usiness dealings and international negotiations in the Eall "treet >ournal and other pu$lications. I then used them as models. I know that things are missing in my life, but I have an exciting career that occupies my every waking hour. Keeping myself busy keeps my mind off what I may be missing. Sometimes parents and professionals worry too much about the social life of an adult with autism. I make social contacts via my work. If a person develops her talents, she will have contacts with people who share her interests.
De
I cannot emphasi,e enough the importance of developing a talent area such as drafting commercial art custom ca$inetwork fiing cars or computer programming. (hese things will provide an intellectually satisfying career. My life would not be worth living if I did not have intellectually satisfying work. My career is my life. Sometimes professionals working with people with autism become so concerned about the person's social life that developing intellectually satisfying employment skills is neglected.
Ehen high functioning autistic or !sperger3s children reach 9th or 8th grade they need mentor teachers to teach them skills such as computer programming. I had a wonderful high school science teacher who taught me to use the scientific research li$rary. %omputers are a great field $ecause $eing weird is okay. ! good programmer is recogni,ed for his'her skills. I know several very successful autistic computer programmers. (o make up for social deficits autistic people need to make themselves so good that they are recogni,ed for $rilliant work. People respect talent. (hey need mentors who are computer programmers artists draftsmen etc. to teach them career skills. I often get asked /6ow does one find mentorsH/ =ou never know where a mentor may $e found. 6e or she may $e standing
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in the checkout line at the supermarket. I found one of my first meat industry mentors when I met the wife of his insurance agent at a party. "he struck up a conversation with me $ecause she saw my hand em$roidered western shirt. I had spent hours em$roidering a steer head on the shirt. Post a notice on the $ulletin $oard at the local college in the computer science department. If you see a person with a computer company name $adge approach him or her and show the person work that the person with autism has done. "ince people with autism and !sperger3s are inept socially they have to sell their work instead of their personality. I showed my portfolio of pictures and $lueprints to prospective customers. I never went to the personnel office. I went straight to the engineers and asked to do design )o$s. Creelance work is really great. It avoids many social pro$lems. I can go in and design the pro)ect and then get out $efore I get in social pro$lems. (here have $een several sad stories where an autistic draftsman or technician has $een promoted to a management position. It was a disaster which ended up with the person $eing fired or quitting. &mployers need to recogni,e the person3s limitations. !n ecellent draftsman commercial artist technician or computer programmer may lose their career when promoted to management. (hey should $e rewarded with more pay or a new computer instead of a management )o$. Sin1 ; 78e S017em
I developed this rule system to guide social interactions and my $ehavior. eally ?ad (hings - eamplesD murder arson stealing lying in court under oath in)uring or hitting other people. !ll cultures have prohi$itions against really $ad things $ecause an orderly civili,ed society cannot function if people are ro$$ing and killing each other. %ourtesy ules - &lesD not cutting in on a line at the movie theater or airport ta$le manners saying 3thank you3 and keeping oneself clean. (hese things are important $ecause they make the other people around you more comforta$le. I don3t like it when some$ody else has sloppy ta$le manners so I try to have decent ta$le manners. It annoys me if some$ody cuts in front of me in a line so I do not do this to other people. Illegal ?ut 0ot ?ad - eamplesD slight speeding on the freeway and illegal parking. 6owever parking in a handicapped ,one would $e worse $ecause it would violate the courtesy rules. "ins of the "ystems ""; - eamplesD smoking pot and $eing thrown in )ail for ten years and seual mis$ehavior. ""3s are things where the penalty is so severe that it defies all logic. "ometimes the penalty for seual mis$ehavior is worse than killing some$ody. ules governing seual $ehavior are so emotionally $ased that I do not dare discuss the su$)ect for fear of committing an "". !n "" in one society may $e accepta$le $ehavior in anotherG whereas rules 1 2 tend $e more uniform $etween different cultures. I have learned never to do a sin of the system. (his is one of the reasons I chose celi$acy. It avoids a lot of pro$lems. People with autism have to learn that certain $ehavior will not $e tolerated period. =ou will $e fired no matter how good your work is if you commit an "" at work. People with autism and !sperger3s need to learn that if they want to keep a )o$ they must not commit an "" at work. (he social knowledge required is )ust too comple. !ttempting to date at work is too ha,ardous to one3s )o$. If they want to date they should do it outside of work. (he most successful marriages that people with autism have involved partners with shared work interests. •
•
•
•
Cn9l:1in
I put a great deal of emphasis on employment $ecause I see so many very intelligent people with autism and !sperger3s syndrome without satisfying )o$s. ! satisfying profession made life have meaning for me. I am what I do and think instead of what I feel. +ast year the li$rary at my university was flooded and almost a million $ooks drowned. I cried and cried a$out this. I grieved for the drowned $ooks. It upsets me so much $ecause the thoughts were dying. 0o$ody would ever read these $ooks again. 6owever it turned out that
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the $ooks could $e saved $y free,e dryingG $ut at the time I did not know that this was possi$le. (o me knowledge is something very precious and the destruction of knowledge is really terri$le. #sing my intellect to do work that is useful and make the world a $etter place is very important to me. @nowledge is more important to me than emotion.
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Ma5in6 78e Tran1i7in ;rm 78e (rld ; S98l in7 78e (rld ; (r5 Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e UniS>A> uring my travels to many autism conferences I have o$served many sad cases of people with autism who have successfully completed high school or college $ut have $een una$le to make the transition into the world of work. "ome have $ecome perpetual students $ecause they thrive on the intellectual stimulation of college. Cor many a$le people with autism college years were their happiest ",atmari et al. 1898;. I would like to stress the importance of a gradual transition from an educational setting into a career. I made the transition gradually. *y present career of designing livestock facilities is $ased on an old childhood fiation. I used that fiation to motivate me to $ecome an epert on cattle handling. &quipment I have designed is in all the ma)or meat plants. I have also stimulated the meat industry to recogni,e the importance of humane treatment of livestock. Ehile I was in college I started visiting local feedlots and meat packing plants. (his ena$led me to learn a$out the industry. *any successful people with autism have turned an old fiation into the $asis of a career. I was lucky to find (om ohrer the manager of the local "wift *eat Packing plant and (ed 5il$ert the *anager of the ed iver Ceedlot >ohn Eayne3s feedlot;. (hey allowed me to visit their operations every week. (hey recogni,ed my talents and tolerated my eccentricities. (hese people served as important mentors. &ducators who work with autistic students need to find these people in the $usiness community. I finished up at !ri,ona "tate #niversity with a *aster3s (hesis on cattle handling and chute design. !t the same time I did some freelance writing for the !ri,ona Carmer anchman *aga,ine. (his ena$led me to further learn a$out the livestock industry and develop epertise. *y net step was to get hired for my first )o$ at a large feedlot construction company. &mil Einnisky the construction manager recogni,ed my talents in design. 6e also served as a third important mentor to force me to conform to a few social rules. 6e had his secretaries take me out to $uy $etter clothes. !t the time I really resented this $ut today I reali,e that he did me a great favor. 6e also told me $luntly that I had to do certain grooming niceties such as wearing deodorant. I had to change. I was most interested to read this passage in one of @anner3s papers a$out people with autism that make a successful adaptationD /#nlike most other autistic children they $ecome uneasily aware of their peculiarities and they $egin to make a conscious effort to do something a$out them./ @anner et al. 1872;. &mil was an eccentric guy himself and that may eplain why he hired me. !$out si months after I was hired &mil was fired. I continued to work for a$out a year and I quit $ecause I was asked to participate in some highly questiona$le $usiness practices. Ehile I was at the construction company I learned drafting from avy their wonderful draftsman. avy and I got along he was a shy loner who drew the most $eautiful drawings. Crom contacts I made at the construction company I started doing freelance design work. I started my independent consulting and design $usiness one )o$ at a time. People respect talent and I soon developed a reputation for $eing an epert. Ehile I was slowly $uilding up my $usiness I had enough financial resources so I did not have to take a )o$ at *conald3s to pay the $ills. (he freelance route has ena$led people with autism to $e successful and eploit their talent area. %omputer programming is often a good area. (o get the $usiness started people with autism need someone to help them get some of their initial )o$s. ! freelance $usiness also helps avoid some of the social pro$lems with a )o$ in one place. I can go in do the design )o$ and then get out $efore I get involved in a social situation where I could get into trou$le. ther freelance $usinesses which can work well for people with autism are piano tuner motor repair
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and graphic arts. (hese )o$s all make use of skills that many people with autism have such as perfect pitch mechanical a$ility and artistic talent.
La95 ; S9ial Under17andin6 I soon developed a reputation in !ri,ona for $eing an epert in my field $ut I got into trou$le socially. I caused a $ig $unch of trou$le for (om ohrer *anager of the "wift plant. I did not understand that people have egos and that protecting their egos was often more important that loyalty to the company. I naively $elieved that all "wift employees would always act in the $est interests of their employer. I assumed that if I was loyal and always worked for the good of "wift3s I would $e rewarded. (he other engineers resented me. (hey sometimes installed equipment wrong and they never consulted me. (hey did not like this /nerd/ telling them how to do it. (echnically I was right $ut socially wrong. I caused trou$le for (om ohrer after I wrote a letter to the President of "wift a$out a $ad equipment installation which caused cattle to suffer. (he President was em$arrassed that I had found a fault in his operation. I thought he would $e pleased if I informed him of the mistake instead he felt threatened and told (om to get rid of me. Cortunately (om did not kick me out. ver the years I have learned to $e more tactful and diplomatic. I have learned to never go over the head of the person that hired me unless I have their permission. Crom past eperiences I have learned to avoid situations where I could $e eploited or my employers might feel threatened. I learned diplomacy $y reading a$out international negotiations and using them as models. 5etting in trou$le over the social aspects of work is a pro$lem area for many people with autism. +earning the work part of the )o$ is easy. *any people with autism epect all people to $e good. It is a rude awakening to learn that some people are $ad and they may try to eploit them. (his is a lesson that an independent person with autism must learn. Cor people with autism who take lower level manufacturing )o$s the other employees should $e involved and trained to help the person. (he co-workers need to $e trained to understand autism. ! higher functioning person with autism can avoid trou$le $y keeping his mind on his work. ne man worked for five years in a la$ and his employer was happy with his work. ne day he got into trou$le when he went drinking with the guys and got fired. 6e would have $een $etter off if he had declined. (o avoid pro$lems I keep my contacts with clients in the technical department. !ttempting to date or flirt with people in my client3s work places would cause many pro$lems so I )ust don3t do it.
A:7i1m Fll4-Up S7:die1 (here have $een two ma)or studies on the follow up of adults with autism who have made a satisfactory ad)ustment. ",atmari et al. 1898; descri$ed si high functioning adults who graduated from college and were a$le to live independently. ne of those people $ecame a perpetual student and the other five have )o$s. (here is a tendency for people with autism to $ecome perpetual students $ecause they like the stimulating $ut structured college setting. (wo of the people in ",atmari3s study $ecame salesmen and two worked in a li$rary. (he fifth person $ecame a physics tutor. Physics tutor would $e a good )o$ to do on a freelance $asis. People with autism are often good at teaching others in their areas of special skills. >ason #tley from @entucky mastered the skills to $ecome an &agle "cout and the other scouts liked him $ecause he teaches them to tie knots. (eaching and $eing a salesman involve social interaction $ut it is often one-way interaction where the person with autism gets to talk a$out his area of interest. It does not require a comple understanding of social relations. @anner et al. 1872; followed up nine high functioning cases where a good ad)ustment had $een made. Cive of these people had )o$s. (he )o$s were $ank teller la$ chemist $lue collar !gricultural &periment "tation worker accountant and li$rary page. ne of these people $ounced from )o$ to )o$ due to social pro$lems. (he )o$ placements that were successful did not involve comple social interactions. ! $ank teller3s interactions can $e routine and stereotyped. (he person who $ecame the la$ chemist originally had a nursing )o$. (his )o$ was a disaster $ecause she did not know how to $e flei$le. "he learned from the nursing tet $ook that mothers should nurse their $a$ies for only 2F minutes. Ehen she a$ruptly took the $a$ies
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away from the mothers in the o$stetrics ward they $ecame angry. "he could not understand why. Ehen she switched to the chemistry la$ she was appreciated for her knowledge of chemistry. (he person who is now an accountant got dismissed from a previous )o$ after he was promoted to a supervisory position. I heard a$out another sad case where a man with autism had $een a successful draftsman for many years in an architectural firm. Ehen he was promoted and had to $e involved with clients he was fired. 6e should have $een left working on his drawing $oard. In summary a person with autism can make a successful transition into a )o$ or career. 1. Grad:al Tran1i7in1 - Eork should $e started for short periods while the person is still in school. 2.S:ppr7i
Re;eren9e1 @anner +. odrigue, !. and !shenden ?. 1872;. 6ow far can autistic children go in matters of social adaptationH 'ournal o" Autism and !hildhood Schizophrenia 0ow titledD 'ournal o" Autism and (e)elopmental (isorders; 9D 8-. ",atmari P. ?artolucci 5. ?ond ". and ich ". 1898;. ! follow-up study of high functioning autistic children. 'ournal o" Autism and (e)elopmental (isorders -*D 21-22:. evised Ce$ruary 188A. !n earlier version of this article appeared in The Ad)ocate "ummer 1882.
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Geni:1 Ma0 !e an A2nrmali70 Ed:9a7in6 S7:den71 4i78 A1per6er1 S0ndrme= r Hi68 F:n97inin6 A:7i1m Temple Grandin= P8>D> A11i17an7 Pr;e11r Clrad S7a7e Unio$ for People with !utism or !sperger3s "yndrome.3 Cor many people with !sperger3s and for me my life is my work. +ife would not $e worth living if I did not have intellectually satisfying work. I did not fully reali,e this until a flood destroyed our university li$rary. I was attending the !merican "ociety of !nimal "cience meetings when the flood occurred. I first learned a$out it when I read a$out it on the front page of ;SA Today, a national newspaper. I grieved for the /dead/ $ooks the same way most people grieve for a dead relative. (he destruction of $ooks upset me $ecause /thoughts died./ &ven though most of the $ooks are still in other li$raries there are many people at the university who will never read them. (o me "hakespeare lives if we keep performing his plays. 6e dies when we stop performing them. I am my work. If the livestock industry continues to use equipment I have designed then my /thoughts live/ and my life has meaning. If my efforts to improve the treatment of cattle and pigs make real improvements in the world then life is meaningful. I have $een reading with great satisfaction the many articles in maga,ines a$out +inu free software. People in the $usiness world are not a$le to comprehend why the computer people give their work away. I am una$le to think a$out this without $ecoming emotional. It is no mystery to me why they download their intellectual ideas into the vast evolving and continually improving computer operating system. It is $ecause their thoughts will live forever as part of the /genetic code/ of the computer program. (hey are putting themselves into the program and their Jintellectual 0!/ will live forever in cy$er-space. !s the program evolves and changes the code they wrote will pro$a$ly remain hidden deep within it. It is almost like a living thing that is continually evolving and improving. Cor $oth me and for the programmers that contri$ute to +inu we do it $ecause it makes our lives more meaningful.
Cn7in::m ; Trai71 (here is a continuum of personality and intellectual traits from normal to a$normal. !t what point does a $rilliant computer programmer or engineer get la$eled with !sperger3s. (here is Page A8 of 74
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no $lack and white dividing line. "imon ?aron-%ohen an autism researcher at the #niversity of %am$ridge found that there were 2 W times as many engineers in the family history of people with autism. I certainly fit this pattern. *y grandfather was an engineer who was co-inventor of the automatic pilot for an airplane. I have second and third cousins who are engineers and mathematicians. !t a recent lecture r. ?aron-%ohen descri$ed three $rilliant cases of !sperger3s "yndrome. (here was a $rilliant physics student a computer scientist and a mathematics professor. It is also likely that ?ill 5ates has many !sperger3s traits. !n article in Time Magazine compared me to *r. 5ates. Cor eample we $oth rock. I have seen video tapes of ?ill 5ates rocking on television. !rticles in $usiness maga,ines descri$e his incredi$le memory as a young child. (here is evidence that high functioning autism and !sperger3s "yndrome have a strong genetic $asis. 5. . e+ong and >. (. yer found that two thirds of families with a high functioning autistic had either a first or second degree relative with !sperger3s "yndrome. "ukhelev 0aragan and his co-workers wrote in the 'ournal o" Autism and (e)elopmental (isorders, that educational achievement of the parents of an autistic child with good language skills were often greater than those of similar parents with normal children. r. o$ert Plomin at Pennsylvania "tate #niversity states that autism is highly herita$le. In my $ook Thin=ing in #ictures, I devote an entire chapter to the link $etween intellectual giftedness and creativity to a$normality. &instein himself had many autistic traits. 6e did not learn to speak until he was three and he had a lack of concern a$out his appearance. 6is uncut hair did not match the men3s hairstyles of his time.
Geni:1 i1 an A2nrmali70. It is likely that genius in any field is an a$normality. %hildren and adults who ecel in one area such as math are often very poor in other areas. (he a$ilities are very uneven. &instein was a poor speller and did poorly in foreign language. (he $rilliant physicist ichard Ceynman did poorly in some su$)ects. ! review of the literature indicates that $eing truly outstanding in any field may $e associated with some type of a$normality. @ay edfield >amison from >ohns 6opkins "chool of *edicine has reviewed many studies that show the link with manic depressive illness and creativity. 0.%. !ndreason at the #niversity of Iowa found that 9F percent of creative writers had mood disorders sometime during their life. ! study of mathematical giftedness conducted at Iowa "tate #niversity $y %amilla Persson found that mathematical giftedness was correlated with $eing near-sighted and having an increased incidence of allergies. I recently attended a lecture $y o$ert Cisher at ?arrow 0eurological Institute in Phoeni !ri,ona. 6e stated that many great people had epilepsy people such as >ulius %easar 0apoleon "ocrates Pythagoras 6andel (chaikovsky and !lfred 0o$el. !n article in the ecem$er 2FF1 issue of
T0pe1 ; T8in5in6 (here appear to $e two $asic types of thinking in intellectually gifted people who have !sperger3s or high functioning autism. (he highly social ver$al thinkers who are in the educational system need to understand that their thought processes are different. (he two types are totally visual thinkers like meG and the music math and memory thinkers which are descri$ed in (homas "owell3s $ook Late Tal=ing !hildren I have interviewed several of these people and their thoughts work in patterns in which there are no pictures. "owell reports that in the family histories of late talking music math and memory children 74 percent of the families will have an engineer or a relative in a highly technical field such as physics accounting or mathematics. *ost of these children also had a relative that played a musical instrument. &very thought I have is represented $y a picture. Ehen I think a$out a dog I see a series of pictures of specific dogs such as my student3s dog or the dog net door. (here is no generali,ed ver$al 3dog3 concept in my mind. I form my dog concept $y looking for common
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features that all dogs have and no cats have. Cor eample all of the different $reeds of dogs have the same kind of nose. *y thought process goes from specific pictures to general concepts where as most people think from general to specific. I have no vague a$stract language-$ased concepts in my head only specific pictures. Ehen I do design work I can run three-dimensional full motion /video/ images of the cattle handling equipment in my head. I can /test run/ the equipment on the /virtual reality/ computer that is in my imagination.
Tea98er1 and Men7r1 %hildren and teenagers with autism or !sperger3s need teachers who can help them develop their talents. I cannot emphasi,e enough the importance of developing a talent into an employa$le skill. (he visual thinkers like me can $ecome eperts in fields such as computer graphics drafting computer programming automotive repair commercial art industrial equipment design or working with animals. (he music math and memory type children can ecel in mathematics accounting engineering physics music translating engineering and legal documents and other technical skills. #nless the student3s mathematical skills are truly $rilliant I would recommend taking courses in li$rary science accounting engineering or computers. +earning a technical skill will make the person highly employa$le. (here are few )o$s for mediocre mathematicians or physicists. "ince social skills are weak the person can make up for them $y making themselves so good at something that people will hire them. (eachers need to council individuals to go into fields where they can easily gain employment. *a)oring in history is not a good choice $ecause o$taining a )o$ will $e difficult. 6istory could $e the person3s ho$$y instead of the main area of study in school. *any high functioning autistic and !sperger teenagers get $ored with school and mis$ehave. (hey need mentors who can teach them a field that will $e $eneficial to their future. I had a wonderful high school science teacher who taught me to use the scientific research li$rary. %omputers are a great field $ecause $eing weird or a /computer geek/ is okay. ! good programmer is recogni,ed for his'her skills. I know several very successful autistic computer programmers. ! $ored high school student could enroll in programming or computer-aided drafting courses in a local community college.
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(o make up for social deficits autistic individuals need to make themselves so good that they are recogni,ed for $rilliant work. People respect talent. (hey need mentors who are computer programmers artists draftsmen etc. to teach them career skills. I often get asked /6ow does one find mentorsH/ =ou never know where a mentor teacher may $e found. 6e may $e standing in the checkout line in a supermarket. I found one of my first meat industry mentors when I met the wife of his insurance agent at a party. "he struck up a conversation with me $ecause she saw my hand em$roidered western shirt. I had spent hours em$roidering a steer head on the shirt. Post a notice on the $ulletin $oard at the local college in the computer science department. If you see a person with a computer company name $adge approach him and show him work that the person with autism has done.
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ED> A11i17an7 Pr;e11r Clrad S7a7e Uni
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